Search results

Patients who have intellectual disability and mental illness will occasionally need inpatient treatment. However, research is sparse on psychosocial factors influencing psychiatric units for patients with intellectual disabilities. The aim of this study is to examine whether adults with intellectual disabilities can reliably rate the Ward Atmosphere Scale – Real Ward (WAS‐R).

A total of 17 patients with mild and moderate intellectual disability and 21 staff members were asked to complete the WAS‐R. The authors used six subscales (involvement, support, practical orientation, order and organisation, angry and aggressive behaviour, and staff control) that have proved to be of major importance for patient satisfaction and treatment outcome to measure the patients' and the staff members' perceptions of the treatment milieu. To examine the internal consistency Cronbach's alpha was calculated for the patient and staff scores, respectively.

A total of 16 patients completed the form. Patients with mild intellectual disabilities were able to answer the WAS with some help, whereas patients with moderate intellectual disabilities had major difficulties with understanding more than half of the WAS items. These difficulties were also reflected in the internal consistency scores. Cronbach's alpha was satisfactory (≥0.50) for five subscales for patients with mild intellectual disabilities, but only satisfactory for two of the six subscales for patients with moderate intellectual disabilities.

A replication study should use a shorter version of the WAS‐R, and family or caregivers should answer the WAS‐R additionally to the patients.

This study may encourage more research on treatment milieu for patients with intellectual disability and mental illness.

This chapter reviews the intervention research literature – particularly interventions deemed evidence-based – for students with intellectual disability across academic and life-skills instruction. Although the focus of this chapter is the spectrum of students covered under the term “intellectual disability,” the majority of research on evidence-based interventions for students with intellectual disability focus on students with more moderate and severe intellectual disability, rather than students with mild intellectual disability. The majority of the interventions determined to be evidence-based within the literature for students with intellectual disability – across both academic and life skills – tend to be those that fall within the purview of systematic instruction.

The purpose of this paper is to investigate whether acute inpatient psychiatric staffs’ attitudes and self-efficacy towards adults with mild intellectual disability, were different than towards the general mental health population. And whether their understanding of the policy for those with mental illness and intellectual disability differed.

The study is a between-subject design, using a self-administered postal questionnaire. The sample was all qualified staff from the acute inpatient psychiatric provision of an inner London borough. Potential participants were randomly assigned to two research groups, half being given a questionnaire regarding people with intellectual disability and the other half an identical one regarding people with mental illness. Comparisons were made between the two.

The majority of staff were unaware of the current policy direction for adults with intellectual disability although were on the whole in agreement to the idea that they should access mainstream services. Staff overall did not have more negative attitudes to those with intellectual disability although were less likely to empower or encourage self-advocacy. Staff were significantly less confident that they had sufficient training and experience, and in their perceived ability to be able to communicate, assess and treat adults with mild intellectual disability when compared to those with mental illness.

The response rate and small sample size is a limitation. Further research could usefully look at whether self-efficacy and attitudes differ in different models of mainstream psychiatric care.

Government policy in the UK regarding services for people with intellectual disability advocates for inclusion and equality (Chaplin and Taggart, 2012). Those requiring psychiatric care should access this from mainstream services (Department of Health, 2001, 2009, 2011; Foundation for People with Learning Disabilities et al., 2004; Bradley, 2009.) There are, however, no UK-based studies investigating the views of mainstream acute inpatient psychiatric staff towards their role. Intellectual disability staff have concerns about their attitudes and self-efficacy and it is know that acute care is the setting where most adults with intellectual disability will come across mainstream psychiatric staff. Findings have relevance to managers and staff in both intellectual disability and psychiatric services and could be considered in the context of trying to work together as is the direction of policy.

Students with an intellectual disability historically faced exclusion in both schools and in their communities. Through court cases, legislation, and parental advocacy, students with an intellectual disability were awarded the right to an education, and under the Individuals with Disabilities Education Act, an education in the least restrictive environment. This chapter explores the historical and current state of inclusion for students with an intellectual disability as well as the current and historical research base regarding inclusive educational placements for students with an intellectual disability. The chapter concludes with a discussion of the future of inclusive education for students with an intellectual disability.

The purpose of this study is to analyse the characteristics of all the referrals to the forensic MHIDD service over the past five years and to compare these characteristics to the cohort of service users attending the three general MHID services based in Dublin which are Service 1, Service 2 and Service 3.

This is a cross-sectional study of adults attending the three generic MHID services and the national forensic MHIDD service. The medical files of service users attending the MHID services were reviewed, and data such as age, gender, level of intellectual disability and psychiatric diagnoses were extracted and compiled into a database. The forensic MHIDD service has since its inception maintained a database of all referrals received and reviewed. The characteristics data needed were extracted from the forensic MHIDD database. All these data were then analysed using the Statistical Package for Social Sciences (SPSS).

The majority of the three MHID service users were in the moderate to profound range of intellectual disability, while the majority of the cases assessed by forensic MHIDD had normal IQ, borderline IQ and mild intellectual disability with 66.1%. The prevalence of neurodevelopmental disorder, schizophrenia and emotionally unstable personality disorder in the forensic MHIDD is comparable to the three MHID services. The prevalence of depression, bipolar affective disorder (BPAD), anxiety disorder and obsessive-compulsive disorder (OCD) is higher in the three MHID services than in the forensic MHIDD service.

The FHMIDD received referrals at a greater level of overall ability, with two-thirds of the service users having mild intellectual disability to normal IQ. The prevalence of neurodevelopmental disorder such as ASD and schizophrenia is comparable between the forensic MHIDD and the three MHID services. There is a higher prevalence of depression, BPAD, anxiety disorder and OCD in the three MHID services as compared to the forensic MHIDD service.

The Netherlands is a country where much is regulated, and several departments have made rules, regulations, memoranda and even laws related to people with intellectual disabilities. Large organisations that offer different forms of support dominate the system of care and support. The policy on care for people with intellectual disabilities has, generally speaking, developed away from segregation and towards integration and inclusion. Changes have led to improvement for people with mild and moderate disabilities, although the process is slow. At the same time, the situation for people with profound and multiple disabilities has deteriorated. For a real change in the support system, client‐held budgets are believed to be of primary importance. However, this is still a slow development. This article describes the current organisation of care and support.

Despite the high incidence of aggressive behaviours among some individuals with intellectual disability, Ireland has paid little attention to the prevalence of aggressive behaviours experienced by Registered Intellectual Disability Nurses (RNID). Within services the focus is mainly on intervention and management of such behaviours. Therefore a disparity occurs in that these interventions and management strategies have become the exclusive concern. Resulting in aggressive behaviour being seen as a sole entity, where similar interventions and management strategies are used for ambiguously contrasting aggressive behaviours. Consequently the ability to document and assess-specific behaviour typologies and their prevalence is fundamental not only to understand these behaviour types but also to orient and educate RNIDs in specific behaviour programme development. The paper aims to discuss these issues.

This study reports on a survey of the prevalence of verbal aggression, aggression against property and aggression against others experienced by RNIDs’ within four residential settings across two health service executive regions in Ireland. A purposeful non-random convenience sampling method was employed. Totally, 119 RNIDs responded to the survey which was an adaptation of Crocker et al. (2006) survey instrument Modified Overt Aggression Scale.

The findings of this study showed the experienced prevalence rate of verbal aggression, aggression against property and aggression against others were 64, 48.9 and 50.7 per cent, respectively. Cross-tabulation of specific correlates identifies those with a mild and intellectual disability as displaying a greater prevalence of verbal aggression and aggression against property. While those with a moderate intellectual disability displayed a higher prevalence of aggression against others. Males were reported as more aggressive across all three typologies studied and those aged between 20 and 39 recorded the highest prevalence of aggression across all three typologies. The practice classification areas of challenging behaviour and low support reported the highest prevalence of aggression within all typologies.

The health care of the person with intellectual disability and aggressive behaviour presents an enormous challenge for services. In-order to improve considerably the quality of life for clients, services need to take a careful considered pragmatic view of the issues for the person with intellectual disability and aggressive behaviour and develop realistic, proactive and responsive strategies. To do this, precise knowledge of the prevalence of aggressive behaviours needs to be obtained. This study is the first of its kind in the Republic of Ireland.

The Improving Access to Psychological Therapies (IAPT) programme was established to treat people with mild to moderate depression and anxiety and bring them to recovery. Although the Positive Practice Guide for people with intellectual disabilities was published in 2009, no geographical areas are listed as having a special interest in specifically rolling out IAPT to people with intellectual disabilities. Issues related to whether current IAPT services can meet the needs of people with intellectual disabilities are considered, along with adaptations that would be needed to ensure the service is accessible and meets the needs of people with intellectual disabilities.

This pilot study aimed to investigate whether adults with mild/moderate intellectual disabilities could accurately self‐report their attachment style. It explored whether there is a relationship between attachment style and challenging behaviour and/or mental health problems. Additionally, the paper examines the distribution of attachment styles in people with intellectual disabilities, based on the hypothesis that it might be different to that of the general population.

Adults with intellectual disabilities (n=60) and people who supported them (n=39) completed questionnaires based on Hazan and Shaver's attachment categories and mental health diagnoses. Supporters also provided information about challenging behaviour.

People with mild/moderate intellectual disabilities show the same range of attachment styles as the general population. Links between challenging behaviour and insecure attachment were found, and there was an association between depression and insecure‐avoidant attachment.

Applications of attachment theory in individual therapy and at a policy level are explored in light of the findings, as well as directions for future research. There appears to be a relationship between insecure attachment and depression in people with intellectual disabilities. This has implications for the psychological treatment of people with intellectual disabilities and interventions should be developed that focus on attachment relationships. Attachment behaviour may not be linked to challenging behaviour as directly as has been previously suggested, certainly for people with mild moderate intellectual disabilities.

This study aimed to examine for differences on how symptoms relating to depression and anxiety were reported by males and females with intellectual disability as part of the development of the Self‐Assessment Intervention Package (SAINT), a guided self‐help tool.

Three self‐report questionnaires were administered (The Glasgow Depression Scale – Learning Disabilities (GDS‐LD)), Glasgow Anxiety Scale – Intellectual Disabilities (GAS‐ID) and Self‐Assessment Intervention Package (SAINT) to a group of people with mild intellectual disabilities (n=36), to allow comparison of symptom reporting between genders, in particular examining the SAINT across the two groups.

Statistically significant differences in self‐reported symptoms as assessed with SAINT were found between males and females. The symptoms where related mainly to mood and self‐esteem. Overall, endorsement of self‐reported depressive symptoms was between 2.7‐3.2 times higher in female than male patients.

There was evidence to suggest differences in self‐report and symptom profiles of depression and anxiety of males and females with mild intellectual disabilities with females reporting higher in terms of symptoms using the SAINT. The SAINT is a valid tool for screening and self‐reporting symptoms of anxiety and depression in people with intellectual disabilities.