Editorial

Citation

Hardy, S. and O’Hara, J. (2012), "Editorial", Advances in Mental Health and Intellectual Disabilities, Vol. 6 No. 4. https://doi.org/10.1108/amhid.2012.54206daa.001

Editorial

Article Type: Editorial From: Advances in Mental Health and Intellectual Disabilities, Volume 6, Issue 4

Welcome to our fourth issue of 2012. This issue includes papers covering a varied and informative mix of topics from a novel approach to working with people with personality disorder to implementing the recovery approach in mental health of intellectual disability services. We hope you find them interesting reading as much as we have.

We begin with a paper by Taylor and colleagues at Rampton Hospital, which is home to the National High Secure Centre for people with intellectual disabilities. The paper describes the implementation of a “therapeutic community model”, an innovative approach applied to people with personality disorders who have intellectual disability. The therapeutic community model has been applied to many client groups such as those with substance misuse problems, mental health problems and adolescents with behavioural difficulties. The approach supports the development of self-help and recovery through a structured and organised environment managed by the service user and staff, aiming to produce positive change. This is the first reported use of a therapeutic community with people with intellectual disabilities in a forensic setting. The authors describe the rationale and their early experiences of the intervention. A formal evaluation is currently underway, the findings of which we eagerly await.

Our second paper is a research paper also based on work in a secure setting for people with intellectual disabilities and forensic needs. Quinn and colleagues examined the psychometric properties of the Essen Climate Evaluation Schema (EssenCES) in both low and medium secure settings. The impact of the environment and the way in which an individual relates to and interacts with the care environment is a crucial part of their treatment plan and recovery. The EssenCES focuses on three domains; therapeutic hold, patients’ cohesion and mutual support and experienced safety. This exciting new study for the first time introduces this tool in a new setting and early results report good reliability within the sample studied.

Cultural background can be a strong influence on the way an individual accesses and experiences the range of health and social care services as well as the service they receive. Our next paper by Heer and colleagues explores the cultural context of care giving among people from South Asian communities, specifically those from Sikh and Muslim faiths who are caring for a child with intellectual disabilities in the UK. Using focus groups the authors found three emerging themes across the two groups; making sense of the disability, feeling let down by services and looking to the future. The study highlights the continuing need for developing culturally sensitive services and interventions for those who often feel marginalised.

Over the last few decades the “recovery model” has steadily gained pace across mental health services in North America and the UK yet its implementation for people with intellectual disabilities who have mental health problems remains unclear. Handley and colleagues explore the concept and examine its similarity to other approaches firmly embedded in intellectual disability services and consider how the “recovery” approach could potentially benefit this client group.

Behaviour described as challenging continues to test all those in providing care and support. The challenge to deliver competent, capable and affordable services providing dignified and respectful care continues to be at the forefront of commissioners, clinicians and managers’ minds. The next paper by Koritsas provides a review of prevalence studies and explores the various risk factors that have been associated with challenging behaviour. It is the first of two papers, with the latter appearing in a challenging behaviour themed issue later this year.

We conclude with an audit paper by Griffiths and colleagues exploring the contentious issue of anti-psychotic medication use with people whose behaviour is described as challenging. The audit reviewed the prescribing practice of antipsychotics by an Intellectual Disability Psychiatry department in accordance with standards adapted from nationally recognised guidelines in the UK, including; indication, regular review, documentation of side effects and physical health parameters.

We are continually looking for high quality papers where clinicians, carers and people using services can share their research, expertise and experience and would encourage you to submit a manuscript. We very much hope you have found this issue interesting and welcome suggestions for future papers or themes.

Steve Hardy, Jean O’Hara