Editorial

Editorial

Article Type: Editorial From: Advances in Mental Health and Intellectual Disabilities, Volume 8, Issue 1

Welcome to the first issue of 2014. We hope you had an enjoyable and relaxing holiday season and feel revitalised for the New Year ahead. We begin 2014 with an eclectic mix of interesting and stimulating papers covering topics such as autism, prescribing psychotropic medication, risk and psychological interventions.

Our first two papers involve people with autism. Wilson and colleagues provide a comprehensive review of the NICE clinical guidance for diagnosis and treatment of adults with Autism Spectrum Disorder (ASD). A useful summary of the guidance is provided along with a discussion of the clinical and practical implications. They found the guidance provides an excellent overview of current and state-of-the-art strategies for diagnosis and treatment of ASD and found that the main recommendation for clinicians is to carry out a comprehensive assessment for adults with suspected autism, taking into account co-morbid mental health problems and potential unmet needs. The second paper by Fitzgerald provides an account of the overlap between autism and schizophrenia. Historical perspectives and the development of autism are discussed along with insightful examples from the author's clinical work.

The use of psychotropic medication for people with intellectual disabilities remains a topic of debate among the range of stakeholders. Edwards and colleagues sought to develop a greater understanding of why such medications were prescribed to people with intellectual disabilities. After examining a range of conceptual frameworks to understand this complex issue they developed an ecological model, which aimed to capture the complexity of prescribing.

Risk assessment and management is an integral part of supporting people whose behaviour is described as challenging or those who have committed or are at risk of committing offences. We have two papers exploring these important issues. Turton provides an overview of the literature, examining approaches to risk assessment in both challenging and offending behaviour and then outlines a model for challenging behaviour services. Taylor explores the concept of criminogenic needs, which recently has started to gain attention in the field of intellectual disabilities. Criminogenic needs describes a number of dynamic factors which when changed may result in differences in criminal behaviour; examples may include employments, relationships and substance use. Taylor provides an overview of an approach to identifying such needs in order to inform treatment planning and service delivery, resulting in the development of "The Treatment Need Matrix", an experimental framework for identifying the needs of offenders with intellectual disability.

It has been five years since the Improving Access to Psychological Therapies programme was introduced in the UK and the project has been accessed by more than a million people (Improving Access to Psychological Therapies and Department of Health, 2012). Kirk and colleagues describe a pilot project to evaluate an anxiety management group. The programme was originally designed for the wider population and was adapted for people with intellectual disabilities by a local specialist community team. It comprised nine sessions and recognised measures were used pre- and post-intervention, as well as self-designed tools for skills and knowledge. There was no notable reduction in anxiety following completion of the programme, but improvements were found in levels of skill and knowledge.

The use of Eye Movement Desensitization and Reprocessing (EMDR) for people with intellectual disabilities is relatively new but is gaining recognition. Dilly explores the effectiveness of EMDR in an individual with mild intellectual disabilities currently compulsorily detained in secure care. Over eight sessions, making adjustments to the individuals communication needs, positive outcomes were found post intervention which were maintained at six-month follow up.

All these papers may have direct clinical relevance to your practice and we look forward to receiving more papers from you addressing these areas.

Reference

Improving Access to Psychological Therapies and Department of Health (2012), IAPT Three Year Report: The First Million Patients, HMSO, London