Advances in Mental Health and Intellectual Disabilities最新文献

{"title":"The development and evaluation of an integrated intensive support service","authors":"Karen Dodd, Victoria. Laute, Selven Daniel","doi":"10.1108/amhid-04-2021-0021","DOIUrl":"https://doi.org/10.1108/amhid-04-2021-0021","url":null,"abstract":"\u0000Purpose\u0000This paper aims to describe the development and evaluation of integrated intensive support service (ISS) for adults with learning disabilities who have complex needs and are at risk of admission to an inpatient unit.\u0000\u0000\u0000Design/methodology/approach\u0000Existing services were remodelled. The service explored external service models and established an integrated ISS comprising intensive community support and intensive support beds.\u0000\u0000\u0000Findings\u0000Data indicates that the majority of people referred to the service avoid both admission to an inpatient unit and placement breakdown. Most people admitted to the inpatient unit are not known to community services. Length of stay has significantly reduced.\u0000\u0000\u0000Practical implications\u0000Other services can use the information to remodel how to provide intensive support and avoid admission to an inpatient unit.\u0000\u0000\u0000Originality/value\u0000It demonstrates how remodelling can drive improvements to reduce placement breakdown and risk of admission.\u0000","PeriodicalId":44693,"journal":{"name":"Advances in Mental Health and Intellectual Disabilities","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2021-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44997349","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":"Exploring maintaining gains following therapy during the coronavirus pandemic with adults with an intellectual disability","authors":"J. Purrington, Arthur Nye, N. Beail","doi":"10.1108/amhid-05-2021-0023","DOIUrl":"https://doi.org/10.1108/amhid-05-2021-0023","url":null,"abstract":"\u0000Purpose\u0000The novel coronavirus and associated mitigation efforts have caused significant increases in stress for adults with intellectual disabilities. Such increases in life stress predict an increased risk of relapse following psychological therapy. This contributes to the high global disease burden of common mental health difficulties. Therefore, this paper aims to explore service user experiences of maintaining gains following therapy within the context of the Covid-19 pandemic.\u0000\u0000\u0000Design/methodology/approach\u0000A mixed-methods evaluation was completed in a psychology service based in the North of England which specialises in supporting adults with intellectual disabilities. Descriptive statistics and effect size calculations were used to examine therapeutic outcomes pre-therapy, post-therapy, and at follow-up. These findings informed a framework analysis of eight semi-structured interviews.\u0000\u0000\u0000Findings\u0000Overall, outcome results improved post-therapy and regressed at follow-up. The framework analysis revealed facilitators to maintenance include a recollection of specific aspects of therapy and the regular utilisation of strategies and resources. Conversely, barriers to maintenance include a recollection focussed on personal outcome, a reliance on social support and an inability to remember therapy.\u0000\u0000\u0000Originality/value\u0000This is the only study to the authors’ knowledge examining service user experiences of maintaining gains following therapy within the context of Covid-19. It is hoped that these findings will inform further research and be useful for services in preparing service users for discharge as the Covid-19 pandemic continues and moves towards the post-pandemic phase.\u0000","PeriodicalId":44693,"journal":{"name":"Advances in Mental Health and Intellectual Disabilities","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2021-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48516684","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 complex trauma in families who have children and adults who have a learning disability and/or autism","authors":"Peter Baker, Vivien Cooper, Winnie Tsang, Isabelle Garnett, N. Blackman","doi":"10.1108/amhid-07-2021-0032","DOIUrl":"https://doi.org/10.1108/amhid-07-2021-0032","url":null,"abstract":"Purpose\u0000There is an established literature supporting the idea that families who have children and adults who have a learning disability and/or autism have a greater vulnerability to mental health problems or poor psychological health. There are shortcomings in this literature in that there is a little consideration of the impact the families interaction with services has on their well-being. It is argued that complex post-traumatic stress disorder (CPTSD), with its focus on prolonged chronic exposure to trauma experiences and the recognition that this can occur in adulthood, may well be an appropriate framework to enable a better understanding of the experiences of families.\u0000\u0000\u0000Design/methodology/approach\u0000A total of 214 family members completed a co-produced online survey in relation to potential traumatic events, impacts and support.\u0000\u0000\u0000Findings\u0000The experiences of family carers of children and adults with a learning disability and/or who are autistic would appear to be multi-layered and complex, with many experiencing a wide range of traumatic events with the associated emotional and personal sequela. The reported responses are consistent with CPTSD with 10% of having received a diagnosis of PTSD. Their experience was that the system failed not only to provide support but also created additional trauma.\u0000\u0000\u0000Practical implications\u0000A trauma-informed approach needs to be adopted by agencies and professionals that serve families to ensure they understand their potential contribution to the trauma families experience.\u0000\u0000\u0000Originality/value\u0000To the best of the authors’ knowledge, this is the first study that has attempted to examine the experience of families using the framework of CPTSD.","PeriodicalId":44693,"journal":{"name":"Advances in Mental Health and Intellectual Disabilities","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2021-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49105053","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":"Change processes within team formulations in intellectual disabilities services: what do multi-disciplinary staff find helpful?","authors":"Gemma Hymers, D. Dagnan, B. Ingham","doi":"10.1108/amhid-03-2021-0016","DOIUrl":"https://doi.org/10.1108/amhid-03-2021-0016","url":null,"abstract":"\u0000Purpose\u0000A biopsychosocial case formulation is an important tool for understanding complexity and guiding treatment for people with intellectual disabilities. It has been suggested that formulation meetings develop staff understanding of individuals they support. This study aims to explore the change processes that occur as a result of professional team formulation meetings, and the mechanisms that facilitate and hinder these events.\u0000\u0000\u0000Design/methodology/approach\u0000Eight clinicians who took part in multi-disciplinary team-based formulations in an inpatient mental health service for adults with intellectual disabilities were interviewed. Interviews were examined using thematic analysis.\u0000\u0000\u0000Findings\u0000The key themes identified were: “gaining information”, “altered thoughts” and “focused goals”. These themes were supported by “collaborative working” and “time for reflection” and were hindered by “poor communication and interaction” and inconsistent “staff attendance”.\u0000\u0000\u0000Originality/value\u0000Multi-disciplinary team formulation meetings may have a number of change processes that affect staff knowledge and perception of the people that they support. The facilitation of these processes should be a focus for further development.\u0000","PeriodicalId":44693,"journal":{"name":"Advances in Mental Health and Intellectual Disabilities","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2021-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44563558","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":"Compassion in custody: developing a trauma sensitive intervention for men with developmental disabilities who have convictions for sexual offending","authors":"Jon Taylor","doi":"10.1108/AMHID-01-2021-0004","DOIUrl":"https://doi.org/10.1108/AMHID-01-2021-0004","url":null,"abstract":"","PeriodicalId":44693,"journal":{"name":"Advances in Mental Health and Intellectual Disabilities","volume":"15 1","pages":"185-200"},"PeriodicalIF":1.1,"publicationDate":"2021-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47757275","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":"Mitigating the impact of SARS-CoV-2 on residential facilities for persons with intellectual disability and/or autism spectrum disorder: two experiences from the Italian red zone","authors":"J. Santambrogio, M. Russo, S. Terrevazzi, Gianluca Peschi, M. Clerici, M. Bertelli","doi":"10.1108/amhid-02-2021-0006","DOIUrl":"https://doi.org/10.1108/amhid-02-2021-0006","url":null,"abstract":"Purpose Persons with intellectual disability and/or low-functioning autism spectrum didorder are with high support need (ID/ASD-HSN) are among the people who are most vulnerable to the COVID-19 pandemic. The specific vulnerability and the protective factors for persons with ID/LF-ASD attending residential and rehabilitative facilities have however received little attention. This paper aims to describe how two facilities located in the Italian COVID-19 red zone faced the risks associated with the spread of the pandemic and the results they have achieved so far. Design/methodology/approach Interventions to contrast the spread of the pandemic and preserve clients’ health conditions have been systematically monitored and recorded since the very beginning of the pandemic. Findings 26/138 clients had to undergo clinical screening and laboratory tests for COVID-like symptomatology, but only one resulted affected by COVID-19 and survived. Considering that Lombardy had 89,595 cases and 16,262 deaths (January–May 2020), one COVID-19 case/138 clients is a good result. Temporarily limiting physical contacts with friends/family in favor of reducing the burden of risk and adopting a system of prevention/safety strategies directed for persons with ID/LF-ASD attending and their caregivers have been useful measures. Research limitations/implications Structured or semi-structured interviews (using professional caregivers as informant) to confirm behavioral and emotional changes in the clients could not be carried out because of lack of time and resources (which were captured by the management of the pandemic) and could be the next goal for our residential facilities to implement the management of epidemic acute phases in a research-oriented view. Originality/value This study is a service evaluation report about facing COVID-19 pandemic. Only few such studies are present in medical literature about ID/ASD.","PeriodicalId":44693,"journal":{"name":"Advances in Mental Health and Intellectual Disabilities","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2021-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48862187","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":"Using clinical audit to improve the quality of mental health-care services for people with learning disabilities","authors":"Edward da Costa, D. Adams, Munzer Salmeh, O. Mahmoud, Ekim Yetkili","doi":"10.1108/amhid-03-2020-0006","DOIUrl":"https://doi.org/10.1108/amhid-03-2020-0006","url":null,"abstract":"\u0000Purpose\u0000The over-reliance on psychotropic medication for the management of patients with learning disabilities with behaviour that challenges is well documented.This paper aims to discuss the application of the methodology of clinical audit within community learning disability mental health services to adapt interventions including optimising prescribing practice and behavioural interventions aiming to reduce behaviour that challenges in people with learning disabilities.\u0000\u0000\u0000Design/methodology/approach\u0000Questionnaire-based review of documentation in electronic patient records, covering relevant audit standards in line with NICE and Royal College of Psychiatrists, was carried out in the North Essex Community Learning Disability Service, Hertfordshire Partnership NHS Foundation Trust. The audit included patients on the caseload of consultant psychiatrists.\u0000\u0000\u0000Findings\u0000The audit demonstrated that the prescribing of psychotropic medication was within BNF maximum limits for all patients, evidence of “consent” procedures was being followed in the majority, and there was some evidence of deprescribing attempts.Improvement was required in several areas e.g. undocumented off label prescribing in a significant proportion of patients. Objective measures to record the severity of behaviours and the effects of the medication were being used by clinicians in only a small proportion of patients. A significant proportion of patients have prescribed medication in the absence of appropriate psychological or environmental interventions.\u0000\u0000\u0000Originality/value\u0000As a result of the audit findings, the action plan made recommendations such as the development of a database for tracking the prescribing of psychotropic medicines and routine use of standardised measures. This action has been supported by the pharmacy team. Positive developments include a clinical psychologist taking on the role of leading the development of behavioural intervention strategies.\u0000","PeriodicalId":44693,"journal":{"name":"Advances in Mental Health and Intellectual Disabilities","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2021-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44481424","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":"Impressions about people with intellectual disability of Polish high school students who participated in a workshop led by self-advocates","authors":"Iwona Nowakowska, E. Pisuła","doi":"10.31234/osf.io/82ry4","DOIUrl":"https://doi.org/10.31234/osf.io/82ry4","url":null,"abstract":"PurposeThe aim of the paper is to assess whether participation in a two-session workshop led by self-advocates with mild intellectual disability (ID), supported by professional staff, affects high school students’ impression of people with ID, measured by a self-report questionnaire based on a semantic differential.Design/methodology/approachThe study was paper-pencil questionnaire-based and anonymous, conducted in Warsaw, Poland. Three measurements were performed using two semantic differentials – two weeks before the workshop, one day and three months afterward. In total, 50 high school students in the workshop group and 43 students in the control group took part in the study.FindingsAfter the workshop, people with ID were perceived as more calm, compliant and adult and this change was not observed in the control group.Research limitations/implicationsThe picture of people with ID after the workshop may probably have been even more complex than before. However, the study focuses on a specific intervention and does not include data about other, similar meetings led in another school and by other self-advocates.Practical implicationsIt is worthy to design anti-discriminatory workshops led by the self-advocates to impact the perceptions of people with ID. The particular intervention would benefit from alterations.Social implicationsWorkshops performed by self-advocates with ID may be promising in terms of limiting stereotype formation in target groups of workshops.Originality/valueThis research fills the gap in the longitudinal studies on the changes in the impressions about people with ID following an intervention based on personal contact.","PeriodicalId":44693,"journal":{"name":"Advances in Mental Health and Intellectual Disabilities","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2021-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43116553","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 impact of Covid-19 on access to psychological services","authors":"J. Purrington, N. Beail","doi":"10.1108/AMHID-03-2021-0017","DOIUrl":"https://doi.org/10.1108/AMHID-03-2021-0017","url":null,"abstract":"\u0000Purpose\u0000The novel coronavirus and associated mitigation efforts have produced barriers to accessing services for adults with intellectual disabilities. This paper aims to evaluate the impact of Covid-19 on access to psychological services. The paper evaluates monthly referral rates and psychological distress scores for service users awaiting therapy.\u0000\u0000\u0000Design/methodology/approach\u0000A quantitative service evaluation was completed in a psychology service based in the North of England which specialises in supporting adults with intellectual disabilities. A single case experimental design was used to examine the impact of events in March 2020 on referral rates. Descriptive statistics and effect size calculations were used to examine the impact of prolonged waiting times on psychological distress scores.\u0000\u0000\u0000Findings\u0000Referral rates were examined comparing a 5-year rolling average monthly referral rate for the 12 months prior to March 2020 with the 12 months following. Findings demonstrate that events starting in March 2020 have had a considerable impact on referral rates and rates have not recovered. Eight service users were contacted to determine the impact of prolonged waiting times with results demonstrating increases in psychological distress of large effect size.\u0000\u0000\u0000Originality/value\u0000This is the only paper the authors are aware of examining the impact of the coronavirus on access to services and psychological distress for adults with intellectual disabilities. It is hoped that these findings will be able to inform both policy and practice as services continue to navigate the pandemic.\u0000","PeriodicalId":44693,"journal":{"name":"Advances in Mental Health and Intellectual Disabilities","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2021-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49176739","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 systematic review of adverse childhood experiences (ACEs) with people with intellectual disabilities: an unsafe gap in the literature","authors":"Chloe Crompton, Bethany Duncan, G. Simpson-Adkins","doi":"10.1108/AMHID-10-2020-0024","DOIUrl":"https://doi.org/10.1108/AMHID-10-2020-0024","url":null,"abstract":"\u0000Purpose\u0000This paper aims to systematically review the available evidence that explores adverse childhood experiences (ACEs) in people with intellectual disabilities (PwID). It is important to systematically review this literature as, to date, there is little known about the number of studies in this area, despite the World Health Organization declaring ACE prevention and support as a global public health priority.\u0000\u0000\u0000Design/methodology/approach\u0000Published studies were identified from electronic database searches. Key journals and reference lists were also hand searched.\u0000\u0000\u0000Findings\u0000Two studies met the inclusion criteria and the prevalence and frequency of ACEs experienced by participants of these studies analysed. Overall, due to the small number of studies meeting the inclusion criteria, it is difficult to establish any meaningful conclusions.\u0000\u0000\u0000Originality/value\u0000This appears to be the first systematic review to try and identify a research base looking at the prevalence of ACEs within a PwID population. Findings suggest that this is a highly neglected area of research, and the authors hope to have identified that further evidence is required to draw clearer conclusions about the impact of ACEs on PwID.\u0000","PeriodicalId":44693,"journal":{"name":"Advances in Mental Health and Intellectual Disabilities","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44960046","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}