Advances in Mental Health and Intellectual Disabilities最新文献

{"title":"Facilitating factors for the job placement of workers with intellectual disabilities: supervisors and coworker mentors perspectives","authors":"Miquel Pellicena, Ignasi Ivern, C. Giné, Olga Múries","doi":"10.1108/AMHID-11-2019-0036","DOIUrl":"https://doi.org/10.1108/AMHID-11-2019-0036","url":null,"abstract":"This study aims to contribute to a better understanding of organizational strategies, attitudes and supports that can help people with intellectual disabilities to access competitive jobs through supported employment.,A multiple case study was carried out based on an intentional sampling involving the coworker mentors of six people with intellectual disabilities currently working in standardized environments. Semi-structured interviews were performed with the participants, and an inductive thematic analysis was used for data analysis.,The study identified five critical factors in the work of people with intellectual disabilities in standardized work environments, which potentially could act as facilitators or as obstacles, depending on how they were managed. The study also identified two key factors that acted mainly as facilitators and one as an obstacle.,The study reveals the existence of factors that sometimes act as facilitators and sometimes as obstacles, depending on how they are managed by the company leaders or the disabled worker himself.","PeriodicalId":44693,"journal":{"name":"Advances in Mental Health and Intellectual Disabilities","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2020-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1108/AMHID-11-2019-0036","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42269797","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":"Dysphagia assessment and intervention: evaluating inclusive approaches using video","authors":"S. Guthrie, J. Stansfield","doi":"10.1108/AMHID-04-2020-0007","DOIUrl":"https://doi.org/10.1108/AMHID-04-2020-0007","url":null,"abstract":"\u0000Purpose\u0000Dysphagia experienced by adults with mental health conditions and/or intellectual disabilities (IDs) has been well-reported. However, accessible and inclusive assessment measures to identify and monitor for deterioration in dysphagia are very limited. The purpose of this paper is to explore the use of video to enhance inclusion in dysphagia assessment and intervention for an inpatient setting.\u0000\u0000\u0000Design/methodology/approach\u0000This service evaluation involved adults with IDs and mental illness living in in-patient accommodation and their multidisciplinary team. Participants were invited to film and then reflect on videos and their comments were transcribed for qualitative analysis.\u0000\u0000\u0000Findings\u0000In total, 42 adults gave consent to film, review and discuss mealtime video-clips. Staff feedback was invited. Thematic analysis was conducted for service-user and staff comments. A global theme of “involvement” was identified from the data analysis, with sub-themes of “enhancing participation, insight and incentive”. An additional global theme “clinical benefits” resulted from staff comments. This included sub-themes of breadth of assessment, shared working and outcome measures.\u0000\u0000\u0000Research limitations/implications\u0000Limitations included refusal of video by people with heightened anxiety but these were a minority. Most people showed enthusiasm and enhanced engagement. Practical issues were resolved regarding governance.\u0000\u0000\u0000Practical implications\u0000Video offers a dynamic record of muscle tone, coordination, mealtime experience and individual context benefiting both service-user and staff practice. It stimulates insightful discussion of outcomes and supports the inclusion of service-user perspectives. Further research is indicated to develop a greater understanding of dysphagia in this population. Inclusion of service-users in planning and managing safer mealtimes may be enhanced through the sensitive use of video.\u0000\u0000\u0000Social implications\u0000This evaluation suggests opportunities for improving inclusive approaches for service-users using video to promote insight.\u0000\u0000\u0000Originality/value\u0000Further research is indicated to explore the nature of dysphagia in people with mental health conditions using video as a dynamic and unique resource.\u0000","PeriodicalId":44693,"journal":{"name":"Advances in Mental Health and Intellectual Disabilities","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2020-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1108/AMHID-04-2020-0007","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44113364","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 and evaluating the validity of the behavioural assessment of dysexecutive functioning – intellectual disabilities adaptation (BADS-ID)","authors":"Z. Webb, Karen Dodd, A. Livesey, S. Sunak, C. Marshall, Lee Harrison, H. Liddiard","doi":"10.1108/amhid-12-2019-0043","DOIUrl":"https://doi.org/10.1108/amhid-12-2019-0043","url":null,"abstract":"\u0000Purpose\u0000Assessment of executive functioning is an important element of a comprehensive assessment of intellectual abilities. Few assessments available are accessible for individuals with intellectual disabilities (ID) and none have population-specific norms. This paper aims to describe the adaptation of the behavioural assessment of dysexecutive syndrome (BADS).\u0000\u0000\u0000Design/methodology/approach\u0000Adaptations were made to the BADS tests to create the BADS – intellectual disabilities (BADS-ID). Data from three doctoral dissertations were combined to explore the utility, reliability, validity and component structure of the BADS-ID. Properties of the BADS-ID were compared with the Cambridge Executive Functioning Assessment (CEFA).\u0000\u0000\u0000Findings\u0000The BADS-ID is accessible to IQ range 50–70 and has a two-component structure. It has good inter-rater reliability, but poor internal consistency. It has a good face and content validity but evidence for concurrent and discriminative validity is weak. All properties are comparable to or better than the CEFA.\u0000\u0000\u0000Research limitations/implications\u0000Further research is needed to improve reliability and validity. The development of an accessible test battery with known reliability and validity for individuals with ID should facilitate research into executive functioning in this population. There is the potential to develop population-specific norms from the data.\u0000\u0000\u0000Practical implications\u0000An accessible test battery for individuals with ID is helpful in clinical situations.\u0000\u0000\u0000Originality/value\u0000To the best of the authors’ knowledge, this is the first study to explore the adaptation of the BADS for use with individuals with ID.\u0000","PeriodicalId":44693,"journal":{"name":"Advances in Mental Health and Intellectual Disabilities","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2020-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1108/amhid-12-2019-0043","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43344857","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 mediating role of positive perceptions on coping strategies and psychological well-being among mothers of children with intellectual disabilities","authors":"Simmi Gupta, Aneesh Kumar","doi":"10.1108/AMHID-02-2020-0004","DOIUrl":"https://doi.org/10.1108/AMHID-02-2020-0004","url":null,"abstract":"Research on caregiving has been considering the positive effects experienced by the mothers of children with disabilities. This paper aims to examine whether positive perceptions mediate the relationships between coping strategies used and psychological well-being among mothers of children with intellectual disabilities.,The study opted for a quantitative approach that includes a correlation research design to examine the relationships between the variables of coping, positive perceptions and well-being among mothers of children with intellectual disabilities attending special schools in the metropolitan city Bengaluru, India. The four-factor structure of Brief COPE examined were active avoidance coping, problem-focussed coping, positive coping and religious-denial coping. “Positive perceptions” refer to the positive contributions for the mother from the experiences of raising a child with intellectual disability. Mediation analysis explored the relationship between the variables.,Problem-focussed coping was the most commonly reported coping factor and was associated with higher levels of well-being. Active-avoidance coping was the least commonly reported coping strategy. Positive perceptions partially mediated the relationship between the four coping factors and maternal well-being. These findings indicate that positive maternal perceptions have important implications for the employment of effective coping strategies that are associated with enhancement of psychological well-being.,The focus on positive perceptions would help in understanding the use of coping strategies and planning of support services or interventions. The positive mental health of mothers paves the way for positive developments in the child’s physical and psychological health.","PeriodicalId":44693,"journal":{"name":"Advances in Mental Health and Intellectual Disabilities","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2020-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1108/AMHID-02-2020-0004","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43682694","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":"Troubled beginnings: the adverse childhood experiences and placement histories of a detained adolescent population with developmental disorders","authors":"Deborah J. Morris, E. Webb, E. Parmar, Grace Trundle, A. McLean","doi":"10.1108/amhid-01-2020-0003","DOIUrl":"https://doi.org/10.1108/amhid-01-2020-0003","url":null,"abstract":"\u0000Purpose\u0000People with developmental disorders are significantly more likely to experience adverse childhood experiences (ACEs), although the impact of ACEs on this population is not well understood. Furthermore, considerably less is known about the exposure to, and impact of, ACEs in detained adolescents with complex developmental disorder needs. This paper aims to explore the exposure to ACEs in an adolescent population detained in a secure specialist developmental disorder service.\u0000\u0000\u0000Design/methodology/approach\u0000A retrospective file review was used to explore ACEs and placement histories within a specialist developmental disorder inpatient service. Data was collated for a convenience sample of 36 adolescents, 9 of whom were female, aged 13–20 years (M = 17.28 years).\u0000\u0000\u0000Findings\u0000A total of 33 participants (91.7%) had experienced at least 1 ACE, with 58% experiencing 4 or more ACEs and 36% experiencing 6 or more ACEs. The most common ACEs reported were physical abuse (61.6%), parental separation (58.3%) and emotional abuse (55.6%). The majority of participants had also experienced high levels of disruption prior to admission, with an average of four placement breakdowns (range 1–13, standard deviation = 3.1). ACEs held a significant positive association with the total number of placement breakdowns and total number of mental health diagnoses.\u0000\u0000\u0000Practical implications\u0000Adolescents detained in specialist developmental disorder secure care had, at the point of admission, experienced high levels of adversities and had been exposed to high levels of experienced and observed abuse. The level of exposure to adversity and ongoing disruptions in care suggests that Child and Adolescent Mental Health Services’ developmental secure services should consider adopting dual treatment frameworks of developmental disorder and trauma-informed care.\u0000\u0000\u0000Originality/value\u0000This study explored the early-life and placement experiences of a marginalised and understudied population.\u0000","PeriodicalId":44693,"journal":{"name":"Advances in Mental Health and Intellectual Disabilities","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2020-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1108/amhid-01-2020-0003","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45700052","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":"Flexible assertive community treatment for individuals with mild intellectual disability or borderline intellectual functioning: client variables associated with treatment outcome","authors":"L. Neijmeijer, H. Korzilius, J. Kroon, H. Nijman, H. Didden","doi":"10.1108/amhid-12-2019-0041","DOIUrl":"https://doi.org/10.1108/amhid-12-2019-0041","url":null,"abstract":"Purpose: Recent research on flexible assertive community treatment (FACT) for individuals with mild intellectual disabilities (MID) or borderline intellectual functioning (BIF) has shown positive results. This paper aims to identify which client variables are associated with treatment outcome of FACT. Design/methodology/approach: Analyses were performed on assessments made during a six-year longitudinal study in The Netherlands. Data comprised assessments of 281 clients with at least 2 measurements. Treatment outcome was measured by the learning disability version of the Health of the Nation Outcomes Scales. Demographic variables and dynamic risk variables of the short version of the Dynamic Risk Outcome Scales were selected as potential predictor variables of outcome. Data were analysed using linear mixed models. Findings: Limited awareness of the need for treatment, limited treatment motivation and cooperation, limited social skills, impulsivity and substance abuse were significantly associated with worse treatment outcome. None of the demographic variables influenced treatment outcome significantly, and neither did intelligence quotient or having a judicial or civil measure. Research limitations/implications: Because of the observational design, no causal inferences can be drawn. Practical implications: This study produces guidelines regarding nature and scope of the treatment supply and the competences of professionals working in FACT MID/BIF teams. Originality/value: This paper encourages other countries to make assertive outreach available for people with MID/BIF on a larger scale, taking into account the acquired insights.","PeriodicalId":44693,"journal":{"name":"Advances in Mental Health and Intellectual Disabilities","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2020-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1108/amhid-12-2019-0041","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41516139","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":"Learning disability, autism and the Criminal Procedure (Scotland) Act","authors":"F. Williams, M. Warwick, C. Mckay, C. Macleod, M. Connolly","doi":"10.1108/amhid-09-2019-0028","DOIUrl":"https://doi.org/10.1108/amhid-09-2019-0028","url":null,"abstract":"This paper aims to investigate the use of Part VI of the Criminal Procedure (Scotland) Act 1995 (CPSA) for people with Learning Disability (LD) and/or Autism. This is in the context of a recent review commissioned by the Scottish Government into whether the provisions in the Mental Health (Care and Treatment) (Scotland) Act 2003 (MHA) meet the needs of these groups which would also affect associated legislation such as CPSA.,All CPSA orders active on the 3 January 2018 were identified and analysed for a number of variables including diagnoses, detention length, level of hospital security and medication use.,Of the 580 people on CPSA orders, 69 (11.9%) had LD and 27 (4.7%) had possible/definite Autism. Most people with LD (56.5%) did not have a mental illness or personality disorder. Most (81.2%) had mild LD. There were two patients whose only diagnosis was Autism. Mean duration of detention was longer for those with LD than for those without. Most patients with LD alone were prescribed medication (61.5%) and, if in hospital, were managed in low secure units (59%).,The results indicate that people with LD or Autism are differently affected by the application of the CPSA from other people with mental disorders, and that this is potentially discriminatory, if it is not objectively justified . It supports the stance from the recent review that to reduce the potential for discrimination, substantial changes to MHA and CPSA should be considered in the wider review of the MHA in Scotland.","PeriodicalId":44693,"journal":{"name":"Advances in Mental Health and Intellectual Disabilities","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2020-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1108/amhid-09-2019-0028","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49156411","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":"Conceptualising the therapeutic alliance: exploring the relevance of Bordin’s model for adults with intellectual disabilities","authors":"S. Cameron, James Swanton, D. Dagnan","doi":"10.1108/amhid-11-2019-0034","DOIUrl":"https://doi.org/10.1108/amhid-11-2019-0034","url":null,"abstract":"This study aims to explore the applicability of Bordin’s model of therapeutic alliance in talking therapies for people with intellectual disabilities.,People with intellectual disabilities and therapists in six therapy dyads were interviewed using a qualitative methodology. Data were analysed using thematic analysis to explore how people with learning disabilities constructed the dimensions of therapeutic alliance. Content analysis was then used to focus on therapy bond, therapy tasks and goals to explore the agreement on these dimensions between the therapist and client.,People with intellectual disabilities reported their experience of therapy in a way that initially validates the alliance dimensions of Bordin’s model. There was clear overlap within most dyads in the description of the characteristics of the bond, the tasks undertaken and the goals of therapy. Some therapists described additional goals based on their therapeutic model that were not clearly described by the client working with them.,This study is limited by only including six therapy dyads; however, the results suggest further research on the impact of therapy alliance and how goals and tasks are agreed would be valuable.,Very few studies have explicitly examined the client’s view of therapy alliance.","PeriodicalId":44693,"journal":{"name":"Advances in Mental Health and Intellectual Disabilities","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2020-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1108/amhid-11-2019-0034","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48372309","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 attitudes of medical students towards intellectual disabilities","authors":"R. Abdi, Elizabeth Metcalf","doi":"10.1108/amhid-01-2020-0002","DOIUrl":"https://doi.org/10.1108/amhid-01-2020-0002","url":null,"abstract":"This paper aims to determine whether an inclusive teaching session changes student attitudes towards people with intellectual disabilities (ID). To investigate the impact of an inclusive teaching session in terms of student perceptions.,66 years 4 students at Cardiff University completed the attitudes towards disabled people form B questionnaire (ATDP-B) before and after a communication skills session on ID. Before and after scores were collated and compared using a paired t-test analysis. Common perceptions were identified using anonymised ATDP-B results to conduct five semi-structured interviews and one focus group with nine students. The common perceptions were discussed, alongside how the teaching session tackled them and suggestions for further improvements.,Mean ATDP-B score before the teaching session was 115 (SD = 14.5). Mean ATDP-B score after the teaching session was 122 (SD = 17.2). The teaching session improved scores in the ATDP-B by a mean of 6.92 (4.69, 9.16). A paired t-test found this to be a statistically significant difference, t(65) = 6.20, p < 0.001. Qualitative data was thematically analysed and three main themes were identified: Student identity, patient contact and curriculum content.,This is the first study to investigate the origin of the negative attitudes of medical students, and found they stem from a lack of confidence in their abilities and failure to develop a professional identity. The impact of the teaching session stems from its focus on meaningful patient contact and identifying and overcoming communication barriers.","PeriodicalId":44693,"journal":{"name":"Advances in Mental Health and Intellectual Disabilities","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2020-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1108/amhid-01-2020-0002","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47767352","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":"Improving clinical practice through simulation training on intellectual disabilities: a longitudinal study","authors":"Hannah Iannelli, Camilla Tooley, G. Billon, S. Cross, J. Pathan, C. Attoe","doi":"10.1108/amhid-11-2019-0033","DOIUrl":"https://doi.org/10.1108/amhid-11-2019-0033","url":null,"abstract":"Individuals health with intellectual disabilities (ID) experience comorbid physical and mental health needs and have poorer outcomes resulting in early mortality. Currently, many training provisions based on ID exist; however, limited research supports their effectiveness. High-fidelity simulation is an innovative training mechanism with promising preliminary results. This study aims to evaluate the longitudinal impact of simulation training on clinical practice in ID.,A mixed-method approach was used in this study. A one-day simulation course using actors who had ID was delivered to 39 health-care professionals from across London hospitals. Nine semi-structured interviews were conducted 12–18 months post training.,High-fidelity simulation training is an effective training modality, which has a sustainable impact on participants, their clinical practice and patients. Core features of the training including debriefing, the use and type of actors, scenario design and the facilitators are crucial learning mechanisms which impacts learning outcomes and changes to behaviour in clinical practice and settings.,To the best of the authors’ knowledge, this study is the first to longitudinally evaluate high-fidelity simulation training designed to improve the physical and mental health needs of those with ID. The research begins to bridge an important gap in the current literature, with a need for more research.","PeriodicalId":44693,"journal":{"name":"Advances in Mental Health and Intellectual Disabilities","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2020-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1108/amhid-11-2019-0033","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41303665","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}