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MENTAL HEALTH SERVICES FOR PERSONS WITH INTELLECTUAL DISABILITY

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Disparate services, with lack of co-ordination in service delivery and problems ... safeguards for compulsory admission, treatment procedures, use of seclusion, ... – PowerPoint PPT presentation

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Title: MENTAL HEALTH SERVICES FOR PERSONS WITH INTELLECTUAL DISABILITY


1
MENTAL HEALTH SERVICES FOR PERSONS WITH
INTELLECTUAL DISABILITY
2
Historical Difficulties
  • Conflation of Mental Illness and Intellectual
    Disability - Fools and Mad
  • Opt-out of direct service provision by the State
    resulting in
  • Admission of large numbers of individuals with
    intellectual disability to Mental Hospitals
  • 16 of Mental Hospital population in 1973
  • 7 of Mental Hospital population in 2006
  • De-Designation of Mental Hosptial Units
  • Disparate services, with lack of co-ordination in
    service delivery and problems in planning
    comprehensive service developments
  • No Catchmenting of service delivery

3
STIGMATISATION
  • Range of individual care needs obscured
  • Lack of concepts relating to citizenship and
    rights
  • Problems in normalisation and mainstreaming of
    services

4
MENTAL HEALTH PROBLEMS IN INDIVIDUALS WITH ID
  • Approximately 25,000 people on the NIDD
  • People with mild ID under-represented
  • Risk of Mental Health Problems
  • Severe and Profound ID - 50 will have a mental
    health problem at some time in their lives
  • Mild and Moderate ID - 20 25 will have a
    mental health problem at some time
  • Total prevalence of Challenging Behaviour /
    Problem Behaviour
  • 3,000 people nationally 12 of those on the
    NIDD
  • Prevalence of Challenging Behaviour / Problem
    Behaviour with co-existing MH Problem
  • 1,600 people nationally problems can be severe
    and intractable

5
CHALLENGING BEHAVIOUR
  • Challenging Behaviour
  • Severe behaviour problems in individuals with ID
  • Culturally abnormal behaviours of such intensity,
    frequency or duration that physical safety in
    jeopardy or access to community facilities denied
    or impossible
  • Problem Behaviour
  • Verbal or physical aggression, destructive
    behaviour, self-harming behaviour, sexually
    inappropriate behaviour.
  • Considered a diagnostic category in ID by the
    RCPsych 2004

6
MODERNISING MENTAL HEALTH SERVICES
  • Past experience best described as syncopated
    equilibrium.
  • 1966 Commissions of Inquiry into Mental Illness
    and Mental Handicap
  • 1984 Planning for the Future
  • 2001 Mental Health Act
  • 2002 Mental Health Commission
  • 2006 Vision for Change

7
KEY SERVICE ELEMENTS FOR THE MENTAL HEALTH NEEDS
OF INDIVIDUALS WITH INTELLECTUAL DISABILITY
Prevention and Mental Health Promotion
Crisis Management for Mental Health Problems /
Challenging Behaviour
Early Detection of Mental Health Problems
Specialised MH Services
8
INTERFACE BETWEEN SPECIALIST MENTAL HEALTH OF
TEAM AND OTHER SERVICES
9
SPECIALIST MHID TEAM STAFFING
  • Adults 2 Teams per 300,000 population
  • Children Adolescents 1 Team per 300,000
    population
  • Each Team to comprise
  • 1 Consultant Psychiatrist
  • 1 NCHD
  • 2 Psychologists
  • 2 Clinical Nurse Specialists
  • 2 Social Workers
  • 1 Occupational Therapist
  • Administrative and Support Staff
  • Each team to address both mental health needs and
    challenging behaviour

10
LEGISLATIVE PROTECTION AND CONSENT
  • Need to establish approved units under the 2001
    Mental Health Act
  • Will ensure appropriate safeguards for compulsory
    admission, treatment procedures, use of
    seclusion, restraint etc
  • Need to address issues of Capacity

11
VISION FOR CHANGE RECOMMENDATIONS FOR MH
SERVICES FOR THOSE WITH ID
  • Promotion and maintenance of mental well-being to
    be an integral part of service provision in ID
    Services
  • All individuals with ID to be registered with a
    GP
  • Process of service delivery for mental health
    care to individuals with ID to be the same as for
    all other citizens
  • Detailed, standardised information on the mental
    health of individuals with ID to be gathered by
    the NIDD
  • A national prevalence study of mental health
    problems, including challenging behaviour, to be
    carried out to inform service planning
  • Specialist MHID Services to be catchment-based
    and provided by Multi-Disciplinary Team

12
VISION FOR CHANGE RECOMMENDATIONS FOR MH
SERVICES FOR THOSE WITH ID (2)
  • Two Specialist MHID Teams for adults with
    Intellectual Disability to be provided per
    300,000 general population
  • One Specialist MHID Team for children and
    adolescents with Intellectual Disability to be
    provided per 300,000 general population
  • A range of facilities and services to be put in
    place to provide a continuum of care including
    acute care, rehabilitation care, inpatient care
    and day care
  • Close liaison between ID Services, Specialist
    MHID service and General Practitioner / Primary
    Care services in referral procedures, service
    delivery and follow-up
  • One 10-bed National Forensic Unit to be provided
    with full range of services and facilities

13
MENTAL HEALTH SERVICES FOR PERSONS WITH
INTELLECTUAL DISABILITY
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