Advances in Mental Health and Intellectual Disabilities最新文献

{"title":"Forensic mental health intellectual and developmental disability service: an analysis of referral patterns and comparison with community mental health intellectual disability (MHID) services in Ireland","authors":"Afwan Abdul Wahab, Calvin Har, Sarah Casey, Hugh Ramsay, Brendan McCormack, Niamh Mulryan, Anita Ambikapathy, Anthony Kearns","doi":"10.1108/amhid-06-2023-0020","DOIUrl":"https://doi.org/10.1108/amhid-06-2023-0020","url":null,"abstract":"Purpose 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. Design/methodology/approach 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). Findings 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. Originality/value 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.","PeriodicalId":44693,"journal":{"name":"Advances in Mental Health and Intellectual Disabilities","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135162134","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adherence to care and treatment review policy and impact on length of stay","authors":"Lucy Jade Jones, Ceri Woodrow","doi":"10.1108/amhid-07-2023-0023","DOIUrl":"https://doi.org/10.1108/amhid-07-2023-0023","url":null,"abstract":"Purpose The purpose of this clinical audit was to review the adherence to the 2017 care and treatment review policy across two NHS assessment and treatment units. Care and treatment reviews should be offered to people with an intellectual disability and/or autism who are at risk of admission into a mental health hospital. Design/methodology/approach Admission and discharge data was collected across two assessment and treatment units between January 2019 and December 2022. Adherence to the care and treatment review policy was also reviewed as was length of inpatient stay. A retrospective evaluation was conducted. Triangulation of data was collected via the trusts’ electronic patient record system and NHS analytics team. Descriptive statistics, Mann–Whitney U test and a one-way ANOVA with post hoc tests were used in the analysis. Findings An increase in behaviours of challenge and deterioration of mental health were the main reasons for admission. Forty-nine percent (30) of those admitted to the assessment and treatment units accessed a care and treatment review. Care and treatment reviews were more frequently provided for individuals experiencing longer inpatient stays. Originality/value There is limited evidence relating to outcomes and impact of care and treatment reviews. Further research is required to explore effectiveness of care and treatment reviews to understand benefits and appropriately prioritise resource.","PeriodicalId":44693,"journal":{"name":"Advances in Mental Health and Intellectual Disabilities","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135219898","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Universal Needs Based Resource Assessment (UNBRA) an objective approach to evaluate resources needed to support people with intellectual disability in an inpatient setting","authors":"Susanne Meddings, Mahesh M. Odiyoor, Holly Eick, Katie Kavanagh, S. Jaydeokar","doi":"10.1108/amhid-05-2023-0015","DOIUrl":"https://doi.org/10.1108/amhid-05-2023-0015","url":null,"abstract":"\u0000Purpose\u0000There are no existing tools to capture resources needed to support people with intellectual disability in an inpatient setting on an individual patient basis. The purpose of this paper is to describe the development of a new tool called Universal Needs Based Resource Assessment (UNBRA).\u0000\u0000\u0000Design/methodology/approach\u0000Using the Delphi method, focus groups were used to generate factors determining resource use. From these, themes were identified, a scoring system was created and the UNBRA tool was developed. This was piloted in two NHS inpatient units and modified following feedback.\u0000\u0000\u0000Findings\u0000The UNBRA tool holistically assesses resource requirements of an individual with intellectual disability supported in an inpatient setting. It considers ten factors grouped into the six themes of staffing, indirect work, clinical/ multi-disciplinary work, incidents, carer link activity and discharge process. UNBRA scores allow intra- and interpersonal comparison as well as comparison between units and can support resource allocation and operational decision-making.\u0000\u0000\u0000Originality/value\u0000To the best of the authors’ knowledge, there is no suitable existing tool to capture individual resource requirements of patients in intellectual inpatient settings. The development of the UNBRA tool fills this gap.\u0000","PeriodicalId":44693,"journal":{"name":"Advances in Mental Health and Intellectual Disabilities","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2023-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44153712","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A survey of therapists’ experience of ending therapy with people with intellectual disabilities","authors":"Yasmine Dunn, S. Summers, D. Dagnan","doi":"10.1108/amhid-04-2023-0012","DOIUrl":"https://doi.org/10.1108/amhid-04-2023-0012","url":null,"abstract":"\u0000Purpose\u0000A range of adaptations and therapy processes have been explored in relation to therapy with people with intellectual disabilities; however, there remain a few areas of therapy practice that have not yet been considered in depth. This study aims to report the results of an online survey of the practice of therapists working with people with intellectual disabilities in managing endings in therapy.\u0000\u0000\u0000Design/methodology/approach\u0000Thirty-one therapists working with people with intellectual disabilities responded to an online survey. The data were analysed using reflexive thematic analysis.\u0000\u0000\u0000Findings\u0000Three superordinate themes were identified: Theme 1 was “preparing for a therapeutic ending” with subordinate themes of “planning early”, “providing boundaries” and “validating feelings”; Theme 2 was “providing a therapeutic ending”, with subordinate themes of “a collaborative decision” and “fostering growth”; and the third theme was “post-ending issues” in which participants acknowledged a “spectrum of emotion”, and, in the case of difficult endings, a sense of “unfinished business”.\u0000\u0000\u0000Originality/value\u0000This is the first systematic exploration of therapy endings as described by therapists working with people with intellectual disabilities. The authors discuss implications for practice and further areas of research.\u0000","PeriodicalId":44693,"journal":{"name":"Advances in Mental Health and Intellectual Disabilities","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2023-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43814630","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effectiveness of positive behaviour support in reducing challenging behaviour and increasing quality of life for individuals with intellectual disability","authors":"K. Dewey, Sean Evans, Sarah Horsley, Ellis Baker","doi":"10.1108/amhid-03-2023-0007","DOIUrl":"https://doi.org/10.1108/amhid-03-2023-0007","url":null,"abstract":"\u0000Purpose\u0000Intensive support teams (ISTs) are often poorly understood, despite reports of their effectiveness in managing behaviour that challenges for individuals with an intellectual disability. This paper aims to contribute to the understanding of ISTs through evaluating one IST’s process and their use of positive behaviour support (PBS) as an intervention.\u0000\u0000\u0000Design/methodology/approach\u0000Participants were obtained from the ISTs discharge database, and pre- and post-intervention data from these participants was used for analysis.\u0000\u0000\u0000Findings\u0000Three-paired sample t-tests found that there were significant differences between pre- and post-scores on the behaviour problem inventory, Health of the Nation Outcomes Scale for people with Learning Disabilities and periodic service reviews, which measure quality of targeted, individualised support. This indicates that challenging behaviour frequency and severity were lower post-intervention, quality of life improved post-intervention and staff teams implemented recommended strategies more consistently by the end of the intervention.\u0000\u0000\u0000Originality/value\u0000This service evaluation captured data over seven-year period, which helps to contribute to the understanding of the effectiveness of ISTs and the PBS framework.\u0000","PeriodicalId":44693,"journal":{"name":"Advances in Mental Health and Intellectual Disabilities","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2023-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49424416","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Waiting for psychological therapy during the covid-19 pandemic: experiences of adults with an intellectual disability","authors":"Rebecca Baxter, G. Rawlings, L. Yates, N. Beail","doi":"10.1108/amhid-08-2022-0028","DOIUrl":"https://doi.org/10.1108/amhid-08-2022-0028","url":null,"abstract":"\u0000Purpose\u0000Measures introduced to mitigate the spread of coronavirus-19 (COVID-19) may have contributed to an increase in waiting times for face-to-face psychological treatments. As adults with intellectual disabilities (ID) are more likely to encounter barriers when accessing remote therapies, it is important they receive appropriate support while waiting. To understand what care is needed, this service evaluation [aimed to] explored the experiences of service users with ID who have waited for treatment during the pandemic.\u0000\u0000\u0000Design/methodology/approach\u0000Seven individuals who had been waiting for psychological therapy during the COVID-19 pandemic, which included those waiting longer than the national health service target of 18 weeks, were interviewed. Data were analysed using framework analysis.\u0000\u0000\u0000Findings\u0000The following four key themes were identified: waiting has been “painful”, related to how service users continued to experience difficulties whilst they waited; tolerating the wait, highlighted that individuals understood the reasons for waiting; use of coping strategies where service users identified both internal and external strategies they had used to cope; and support and contact from the learning disability team, related to how individuals experienced the support they received from the service.\u0000\u0000\u0000Originality/value\u0000To the best of the authors’ knowledge, this service evaluation is the first to explore the experiences of service users with ID waiting for psychological therapy during the Covid-19 pandemic. Results guide suggestions on improving support whilst they are waiting to help prevent further decline.\u0000","PeriodicalId":44693,"journal":{"name":"Advances in Mental Health and Intellectual Disabilities","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2023-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46000819","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating the use of videoconferencing for handover and MDT meetings within an intensive support team","authors":"Elizabeth Megan Mehmet, Jason Lines","doi":"10.1108/amhid-04-2023-0013","DOIUrl":"https://doi.org/10.1108/amhid-04-2023-0013","url":null,"abstract":"\u0000Purpose\u0000This study aims to evaluate the use of videoconferencing when conducting multi-disciplinary team (MDT) and handover meetings within an NHS Adult Learning Disabilities Intensive Support Team (IST). The IST have been conducting MDT and handover meetings “virtually” since the start of the COVID-19 pandemic in March 2020, in line with government guidance. It is pertinent to evaluate the effectiveness of using videoconferencing, as the move to flexible, remote working is detailed within the NHS Long Term Plan.\u0000\u0000\u0000Design/methodology/approach\u0000Participants were members of the IST. A mixed methods approach using an online questionnaire collected participant’s views relating to the use of videoconferencing when conducting MDT and handover meetings, in comparison to previous face-to-face meetings. The questionnaire considered five key areas: accessibility, environment and communication, organisation, continuation of care and data protection and confidentiality. Results were collated and analysed.\u0000\u0000\u0000Findings\u0000Improvements were reported relating to accessibility, as the virtual format allowed for easier attendance, provided greater flexibility in attending and inviting key stakeholders. A reduced sense of team connectedness was reported, related to the virtual environment. The majority of participants reported that they wish to continue to have the option to attend meetings virtually in future.\u0000\u0000\u0000Originality/value\u0000There are no previous papers evaluating the use of videoconferencing within ISTs during the COVID-19 pandemic. This study suggests that the use of videoconferencing to conduct MDT and handover meetings is effective within the IST and highlights points for consideration moving forward.\u0000","PeriodicalId":44693,"journal":{"name":"Advances in Mental Health and Intellectual Disabilities","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2023-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47480767","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Defining the characteristics of an effective psychological therapist for people with intellectual disability and mental health problems: a Q-sort study","authors":"C. Clarke, N. Beail, S. Kellett","doi":"10.1108/amhid-07-2022-0024","DOIUrl":"https://doi.org/10.1108/amhid-07-2022-0024","url":null,"abstract":"\u0000Purpose\u0000There is little consensus regarding what constitutes an effective therapist when working with adults with intellectual disabilities (ID) who have a mental health problem. This study aims to explore whether clusters of clinical psychologists (CPs) could be differentiated with regards to beliefs as to what defines an effective therapist for adults with ID experiencing psychological distress and seeking treatment.\u0000\u0000\u0000Design/methodology/approach\u0000Four interviews with CPs and an associated thematic analysis created the 49-item Q-set. These items were then sorted into a forced quasi-normal distribution by N = 27 CPs via an online Q-sorting task.\u0000\u0000\u0000Findings\u0000Three participant clusters were identified in the principal components analysis that accounted for 49% of the variance. These clusters were labelled the creative collaborator, the reflective expert and the system integrator.\u0000\u0000\u0000Research limitations/implications\u0000Differences exist regarding beliefs as to what the psychotherapeutic approaches effective therapists working with ID and comorbid mental health problems should take. These differences approximated to preferred psychological therapy models. This study is critiqued to enable future research on this topic to progress.\u0000\u0000\u0000Originality/value\u0000To the best of the authors’ knowledge, this is the first study to explore what constitutes an effective psychological therapist for people who have ID.\u0000","PeriodicalId":44693,"journal":{"name":"Advances in Mental Health and Intellectual Disabilities","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2023-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44216236","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Attachment, psychological health and interpersonal functioning: a comparison of clinical and non-clinical groups of people with intellectual disability","authors":"Lucy Bateman, A. Flood, Deanna J. Gallichan, L. De Pascalis","doi":"10.1108/amhid-04-2023-0011","DOIUrl":"https://doi.org/10.1108/amhid-04-2023-0011","url":null,"abstract":"\u0000Purpose\u0000Insecure and unresolved attachments have been linked to poorer psychological health and interpersonal functioning for people with intellectual disabilities (IDs), but research in this area is limited, especially for adults. Studies using the Adult Attachment Projective (AAP) have been restricted to clinical samples, where insecure and unresolved attachments are typically more prevalent. The purpose of this study is to compare clinical and non-clinical groups of adults with IDs on the AAP, plus measures of psychological health and interpersonal functioning, to investigate whether group differences found in the typically developing population are also present for adults with IDs.\u0000\u0000\u0000Design/methodology/approach\u0000A cross-sectional, between-group design was used. Adults with IDs (clinical group n = 11 and non-clinical group n = 13) completed measures of attachment, psychological distress/positive well-being and interpersonal functioning. Attachment classifications were compared in the clinical versus non-clinical groups. Measures of psychological distress, positive well-being and interpersonal functioning were compared between those with insecure-organised versus unresolved classifications.\u0000\u0000\u0000Findings\u0000No participants were classified as secure, and there were high rates of unresolved attachment. There were no differences between clinical and non-clinical groups with regards to the distribution of insecure-organised (i.e. dismissing or preoccupied) versus unresolved classifications. There were no differences between groups with regards to psychological distress, positive well-being or interpersonal functioning. The authors consider limitations in the method of group differentiation and suggest further research to better understand the development of internal working models of attachment in this population.\u0000\u0000\u0000Originality/value\u0000To the best of the authors’ knowledge, this study is one of only three to examine attachment state of mind in adults with IDs using the AAP and the first to examine differences between clinical and non-clinical groups.\u0000","PeriodicalId":44693,"journal":{"name":"Advances in Mental Health and Intellectual Disabilities","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2023-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46152429","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Developing an outcome measure for an adult intellectual disabilities intensive support team – a practice paper","authors":"Jason Lines, Kiran Krishnadas","doi":"10.1108/amhid-11-2022-0043","DOIUrl":"https://doi.org/10.1108/amhid-11-2022-0043","url":null,"abstract":"\u0000Purpose\u0000This paper aims to outline the initial pilot use of the client complexity matrix (CCM), an outcome measure developed for an NHS Adult Intellectual Disabilities Intensive Support Team (IST) in the West Midlands of England.\u0000\u0000\u0000Design/methodology/approach\u0000A mixed method approach was used to report the results and evaluate the use of the CCM within this IST. The CCM was trialled for six months between January 2022 and June 2022. CCM scores pre and post IST intervention were analysed via t-test, and qualitative feedback from clinicians is detailed.\u0000\u0000\u0000Findings\u0000Analysis suggests the CCM captures service success showing a significant decrease in complexity and risk post-intervention. Qualitative comments from clinicians were generally positive; however, there were requested changes regarding specific presentations, use of labels/language and for a digital version.\u0000\u0000\u0000Research limitations/implications\u0000The tool is not co-constructed with the client. Because of this IST’s caseload, the sample size was small. Only one clinician was asked to complete the CCM pre and post intervention. Future use of the measure will encourage two clinicians to complete the measure to evidence its inter-rater reliability. Each client’s specific presentation was not explicitly analysed here.\u0000\u0000\u0000Practical implications\u0000The CCM will be updated using the feedback from clinicians and from the peer review process. Research that examines the generalisability of this measure to other IST services would be beneficial.\u0000\u0000\u0000Originality/value\u0000The CCM appears to fill a gap in outcome measurements for this IST service which looks at breadth and depth of client complexity and risk.\u0000","PeriodicalId":44693,"journal":{"name":"Advances in Mental Health and Intellectual Disabilities","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2023-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47416315","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}