Emerald | Advances in Mental Health and Intellectual Disabilities | Table of Contents

Gender issues for people with intellectual disabilities and mental health problems: asking what service users and staff think.

Fri, 12 Jul 2013 00:00:00 +0100

Abstract

Purpose - Purpose: The current qualitative study investigates service users', support staff’s and community team members' views of gender differences in cause and presentation of mental health problems, whether current services respond differently to men and women with mental health problems and areas in which services can become more gender sensitive. Design/methodology/approach - Methodology: Two focus groups were conducted with service users with intellectual disabilities and mental health problems in addition to two focus groups with a variety of staff. Subsequently, individual interviews were conducted with both male and female staff members employed in residential and community intellectual disability services. The number of participants totalled 54 (16 service users and 38 staff). Thematic analysis was adopted in order to identify dominant themes in the discourse of these stakeholder groups. Findings - Findings: The analysis produced a number of themes which include: compliance versus challenge; vulnerability; expression of emotion; gender equality; same sex support; caring qualities; and boundaries. Research limitations/implications - Implications: A number of suggestions for improving services are discussed in the context of the current findings. Originality/value - These are preliminary findings in an area of research which has as yet received little attention.

Gender differences in self-reported symptoms of depression and anxiety in adults with intellectual disabilities

Fri, 12 Jul 2013 00:00:00 +0100

Abstract

Purpose - This study examined for differences on how symptoms relating to depression and anxiety were reported by males and females with intellectual disability as part of the development of the Self-Assessment Intervention Package (SAINT) a guided self-help tool.Design/methodology/approach - Three self-report questionnaires were administered (The Glasgow Depression Scale - Learning Disabilities (GDS-LD), Glasgow Anxiety Scale – Intellectual Disabilities (GAS-ID) and Self-Assessment Intervention Package (SAINT) to a group of people with mild intellectual disabilities (n=36), to allow comparison of symptom reporting between genders in particular examining the SAINT across the two groups. Findings - Statistically significant differences in self-reported symptoms as assessed with SAINT were found between males and females. The symptoms where related mainly to mood and self-esteem. Overall, endorsement of self-reported depressive symptoms was between 2.7 – 3.2 times higher in female than male patients. Originality/value - There was evidence to suggest differences in self-report and symptom profiles of depression and anxiety of males and females with mild intellectual disabilities with females reporting higher in terms of symptoms using the SAINT. The SAINT is a valid tool for screening and self-reporting symptoms of anxiety and depression in people with intellectual disabilities.

Service users’ experiences, understanding and hopes about care in an inpatient intellectual disability unit: a qualitative study.

Fri, 12 Jul 2013 00:00:00 +0100

Abstract

Purpose - Service user involvement in evaluating provided services is a core NHS concept. However individuals with intellectual disabilities have traditionally often had their voices ignored. There have been attempts to redress this, though much work has been quantitative, and qualitative study has more often explored populations transitioning to more mainstream care and those with milder disabilities. We set out to explore the views of individuals with more severe intellectual disabilities who were resident inpatients on what helped or hindered their care.Design/methodology/approach - Qualitative analysis through semi-structured interviews of eight (3 male, 5 female, mean age 33) resident service users with severe intellectual disabilities.Findings - Sub-categories of staff personality, helpful relationships, and the concept of balanced care emerged under a core category of needing a secure base. Clients were very clearly able to identify and delineate: personal attributes of staff; clinical means of working; and the need to balance support with affording independence and growth. They further noted factors that could help or hinder all of these, and gave nuanced answers on how different personality factors could be utilized in different settings.Originality/value - Little work has qualitatively explored the needs of residential clients with severe intellectual disabilities. Our data show that exploring the views of more profoundly disabled and vulnerable individuals is both viable and of significant clinical value. It should aid staff in contemplating the needs of their clients; in seeking their opinions and feedback; and considering that most ‘styles’ of personality and work have attributes that clients can value and appreciate.

Biscuits and Perseverance: Reflections on supporting a Community Intellectual Disability Team to reflect.

literatinetwork@emeraldinsight.com (Esther Wilcox) — Fri, 12 Jul 2013 00:00:00 +0100

Abstract

Purpose - This paper aims to share information and reflections on the process of setting up case formulation meetings in a Community Intellectual Disability Team supporting adults with intellectual disabilities. Design/methodology/approach - The case formulation meeting was set up and pioneered by a Clinical Psychologist working in the team. This paper offers a description of the process of setting up the meetings and experiences of initial meetings. Findings - Evaluations of the meetings were consistently positive, but attendance from the team members was dependent on ongoing marketing of the meetings by the team’s psychologist. Feedback suggested that there may be direct benefits to the clinical work of the team and that the conversations allowed for improved management of risk. This suggests that time spent on facilitating such meetings can help to improve the quality of a service. Originality/value - Other papers have helpfully shared experiences of setting up formulation meetings in other settings. To the author’s knowledge this is the first paper which shares the experience of setting up and running a case formulation meeting in an adult community intellectual disability team setting. The paper’s focus on meetings which floundered, and focus on lessons learnt for the continuation of the meetings is also of practical value.

QUALITY OF LIFE AND LIVING ARRANGEMENTS FOR PEOPLE WITH INTELLECTUAL DISABILITY

Fri, 12 Jul 2013 00:00:00 +0100

Abstract

Purpose - Recent international experiences of community inclusion have produced a major change in residential care for people with intellectual disability (ID). Assignment and outcome assessment through new person-centred measures are raising increasing interest, however the information on Quality of Life and accommodation is still limited. This paper provides an overview of the application of quality of life models and the size of the provision of different living arrangements.Design/methodology/approach - A systematic mapping of the literature of the last decade was followed by an expert guided review of the available evidence.Findings - QoL outcomes measures of living arrangements in people with ID show conceptual and methodological challenges. The following key topics were identified: 1) individual level: Issues related to health status, behavioural problems and other personal factors (ageing, choice and empowerment); 2) family and peers; 3) local level: accommodation, architecture and urbanization, and economic aspects (deprivation and costs); 4) macrolevel: social participation (community inclusion). The residential solutions that are currently considered of highest efficiency are small apartments in the community and 'cluster centers'.Originality/value - The level of Quality of life is very relevant in the assessment of living arrangements in people with ID although its assessment still shows significant limitations. Some accommodation typologies seem more effective than others. New conceptual models of inclusive residential care support the convenience of a wide range of accommodation alternatives that may fit the individual needs of a highly heterogeneous population group. A unique residential alternative, albeit optimal from a community care perspective, may not be adequate for all persons with ID.

The relationship between language and social competence in high-risk preschoolers

Fri, 12 Jul 2013 00:00:00 +0100

Abstract

Purpose - This research study examines: (a) whether preschoolers at risk form a homogenous or a heterogeneous group of high-risk children, and (b) in case preschoolers form a heterogeneous group, what are the distinctive characteristics of SLI and MID groups in language acquisition and social competence that make differential early intervention necessary. Design/methodology/approach - One hundred and forty three (143) Greek preschoolers aged 4.5 through 5.5 participated in the study. Among them, according to DTLA-P:3, forty-two (42) with mild intellectual disabilities and forty-one (41) with specific language impairments were detected. Sixty (60) typically developed children were also detected. Children’s categorization to the above groups was verified by the ?-a-?-? Language Competence Test Level I, which was used to estimate intra-individual differences in language competence. To assess peer relations, a peer relation checklist was developed and standardized.Findings - The findings of this study support the approach of the two distinct groups of high-risk preschoolers in terms of their language and social characteristics. Originality/value - Research findings highlight the different educational needs of high-risk preschoolers, which make necessary the differential use of preschool curricula.

Cognitive Behaviour Therapy With A Woman In Her Twenties With A Mild Intellectual Disability Presenting With Psychogenic Non-Epileptic Seizures

literatinetwork@emeraldinsight.com (Catherine Isabel Atnas, Tessa Lippold) — Fri, 12 Jul 2013 00:00:00 +0100

Abstract

Purpose - This case report describes the treatment of a woman (Rachel) in her twenties was referred to the Community Team for People with an Intellectual disability by her neurologist as she wanted help with reducing the frequency of psychogenic non-epileptic seizures (PNES). Design/methodology/approach - CBT was used as the therapeutic approach. The first stage of intervention focussed on reducing the frequency of PNES through relaxation and distraction techniques. We then used graded exposure to enable Rachel to achieve her goal of going on the bus alone. The intervention process was completed over 12 sessions. Findings - Outcome was measured using self-report of seizure frequency. Rachel has successfully reduced the frequency of PNES from 7 to 2-3 per week, and has managed to successfully complete several bus journeys on her own, working through the hierarchy we had developed. We also completed pre and post therapy measures for anxiety and depression. Her scores on the Glasgow Anxiety Scale for Intellectual Disability reduced from 23 to 19 whilst she scored sub-clinically on the Glasgow Depression Scale for Intellectual Disability. Originality/value - this case report seeks to add to the evidence base of CBT as a viable treatment for PNES whilst also demonstrating that the approach can be adapted to meet the needs of clients with intellectual disabilities.

Review of: McGilvery, S. & Sweetland, D. (2011). Intellectual Disability and Mental Health: A Training Manual in Dual Diagnosis. New York: NADD Press

literatinetwork@emeraldinsight.com (Helena M Priest) — Fri, 12 Jul 2013 00:00:00 +0100

Abstract

Not available.

Editorial Issue 7.4

literatinetwork@emeraldinsight.com (Steven Hardy) — Fri, 12 Jul 2013 00:00:00 +0100

Abstract

Not available.