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Mental health services for people with intellectual disability in the UK

Mental health services for people with intellectual disability in the UK. Dr Bhathika Perera Consultant Psychiatrist in Intellectual disability Haringey- North London, UK 15th November 2018. London Borough of Haringey. London borough of Haringey.

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Mental health services for people with intellectual disability in the UK

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  1. Mental health services for people with intellectual disability in the UK • Dr Bhathika Perera • Consultant Psychiatrist in Intellectual disability Haringey- North London, UK • 15th November 2018

  2. London Borough of Haringey

  3. London borough of Haringey

  4. Mental health and mental illness in people with ID • Very high risk of mental illness/mental health issues in people with ID

  5. Case • 22 year old man, Moderate ID, Autism, behavioural difficulties, hearing voices when 17-18 years- ?diagnosis of Schizophrenia • Main stream mental health services- Treated with antipsychotic medications, antianxiety medications, different psychological interventions, OT assessments • ID services- ADHD, Anxiety disorders- Treatment of ADHD, extra support to go to college, confidence building, support family, • Starting an apprenticeship

  6. Case • 22 year old man, Moderate ID, Autism, behavioural difficulties, hearing voices when 17-18 years- ?diagnosis of Schizophrenia • Main stream mental health services- Treated with antipsychotic medications, antianxiety medications, different psychological interventions, OT assessments • ID services- ADHD, Anxiety disorders- Treatment of ADHD, extra support to go to college, confidence building, support family, • Starting an apprenticeship

  7. Mental Health services for people with ID • Community services • Community mental health services for people with ID • Community Forensic services for people with ID • Inpatient services • Inpatient ID services for Mental disorder/challenging behaviour • Inpatient ID Forensic services

  8. Community Mental health services- Adults NHS Social services Integrated teams (Health and Social care) Psychiatrists in ID, Trainee doctors, Psychologists, LD nurses, Occupational therapists, Speech and Language therapists, Physiotherapists, Music/drama therapists , other allied health care staff. Social workers and other support staff.

  9. Community Mental health services- Adults • Referrals – Health professionals, Other Id services, self referrals • Eligibility – • Mild- Profound, only Moderate to Profound • Over 18 • Registered with a local GP

  10. Mental health pathways • Mental illness pathway • Challenging behaviour pathway • Dementia pathway • Autism pathway • ADHD pathway • Others

  11. Community Mental health services- Children with ID • Not well organised • Child and adolescent mental health services • Paediatricians • Children and adolescent ID teams • Under resourced

  12. Integrated vs non-integrated • Advantages • Mental disorders- associated with social care issues • Multidisciplinary approach • Budgets • Reduce admissions to psychiatric units • Holistic approach • Disadvantages • Different models of working -Health care vs Social care • Different targets • Difficulty understanding each others roles • Blurred working boundaries • Difficulties in accessing training

  13. Intensive Support Teams • Management of challenging behaviour and prevent admission

  14. Other support in the community • Day centres/Day opportunities • Education- Colleges • Voluntary schemes • Employment • Hospital Liaison services • Reasonable adjustments in various settings

  15. Inpatient services for people with IDSignificant efforts to prevent admissions • Main stream mental health beds • Specialist ID inpatient units Approximately 2,500 people with ID or Autism in hospitals in England- 2017

  16. Offenders with ID & mental disorders • Inpatient forensic units for people with ID- Low, Medium and high secure • Community Forensic services

  17. Looking after people with ID and mental disorders • Families • Care providers (residential, supported living, shared living etc)

  18. Community provisions- challenges • Lack of providers • Lack of skilled staff • Governance/safe guarding within provider organisations

  19. Works cited Bhathika Perera, Ken Courtenay, (2018) "Mental health services for people with intellectual disability in the United Kingdom", Advances in Mental Health and Intellectual Disabilities, https://doi.org/10.1108/AMHID-03-2018-0017

  20. Email- Bhathika.Perera@nhs.net Twitter @bathika Thank you

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