A Survey on the Learning Disability Service User's View of Admission to an Acute Psychiatric Ward

Abstract

The prevalence of mental illness in people with learning disability (LD) is higher when compared to the general population (Corbett, 1979; Lund, 1985; Deb et al., 2001; Taylor et al., 2004). Although the current trend is focused on “treatment in the community”, at times this is no longer a viable option and inpatient treatment becomes a necessity. The model of inpatient care for people with learning disabilities could vary from utilization of generic services (Nolan et al., 1992: Singh et al., 1994) to being admitted to specialist LD units (Xentidis et al., 2004). The recent Government document “Valuing people” (Department of Health, 2001) advocates the principle of people with learning disabilities accessing mainstream services with the support of the specialist learning disability teams. The advantages of these service users receiving treatment in general psychiatric inpatients units include lack of discrimination and stigmatization (Chaplin, 2004) and perhaps accessing a service which is more local and closer to home. The potential lack of an appropriate peer group leading to rejection, isolation and at times exploitation of this vulnerable group of individuals (Kwok, 2001), the unsettled environment, lack of staff skills in communicating and identifying signs and symptoms of mental illness (Bouras and Holt, 2001) as well as negative attitudes of the staff are some of the disadvantages. Inappropriateness of a busy, noisy environment and lack of adequately trained staff in LD issues often makes the generic units an inappropriate admission unit for people with more severe degrees of LD. For many years in North Hertfordshire the established practice has been an “integrated model of care” i.e. service users with learning disabilities and mental health problems being admitted to “inpatient beds” in the mainstream mental health unit. During the inpatient episode, the LD psychiatrist maintains clinical responsibility for these patients.