Editorial

Citation

(2013), "Editorial", Advances in Mental Health and Intellectual Disabilities, Vol. 7 No. 4. https://doi.org/10.1108/amhid.2013.54207daa.001

Editorial

Editorial

Article Type: Editorial From: Advances in Mental Health and Intellectual Disabilities, Volume 7, Issue 4.

This issue provides an eclectic mix of stimulating papers from a number of perspectives including gender to examining the view of people with severe intellectual disabilities living in residential care, the development of a case formulation forum in a community intellectual disability service, quality of life in relation to residential services, the risk and impact of communication development in children and a case study exploring the use of cognitive behaviour therapy in psychogenic non-epileptic seizures (PNES).

In the wider population gender differences has been an issue in mental health problems, notably depression, anxiety, post-traumatic stress disorder and alcohol dependence relating to prevalence. The first paper by Kroese and colleagues used focus groups to determine the views of people using services and staff to examine gender issues relating to mental health problems and how services respond to each gender. Differences were highlighted and emerging themes included vulnerability, equality, same sex support and boundaries.

The use of guided self-help for common mental health problems such as anxiety and depression is a valid intervention in primary health care. It is a structured approach that supports individuals to develop coping skills to manage their difficulties, which is part of the stepped approach to care. Utilising the self-assessment intervention package (SAINT) (Chaplin et al., 2012) Chester and colleagues examined gender differences in the reporting of symptoms of anxiety and depression. Significant differences in self-reported symptoms were found between males and females, with self-reported depressive symptoms being between 2.7 and 3.2 times higher in female than male patients.

The basic assumption that people with intellectual disabilities should be included and have a say in every aspect of their lives and the services they use, have been at the forefront of service philosophy for several decades, but the inclusion of people with higher support needs can be challenging. Lloyd and colleagues describe a study where they elicited the view of people with severe intellectual disabilities using residential services on what helped or hindered their care. From the themes that emerged staff personality and balancing support with independence appeared to be pertinent factors.

Often mental health professionals will work with people with intellectual disabilities who have a range of complex needs, multi-morbidity and requiring interventions that cross several care pathways. In Wilcox's paper the development and evaluation of a case formulation meeting at a community intellectual disability team is described. Evaluations of the forum were positive, benefits to clinical work were noted and specifically in the management of risk.

The inclusion of people with intellectual disabilities within their local communities is widely accepted throughout the world, although the pace of change differs considerably. We have seen a move from large institutions to smaller community residential settings, however, information on quality of life in relation to accommodation is limited. Bertelli and colleagues paper provides an overview of the application of quality of life models to residential services.

School readiness is a term used to describe the developmental level required to enter into formal school education. Tzouriadou and colleagues completed a study that examined whether preschoolers with developmental disabilities who were at risk from failing to meet school readiness form a homogenous or a heterogeneous group. In particular with the heterogeneous group, what were the distinctive characteristics of specific language impairment and mild intellectual disabilities in language acquisition and social competence that make differential early intervention necessary.

We conclude this issue with a case study by Atnas and Lippold that describes the treatment of a woman with intellectual disabilities using cognitive behaviour therapy as to help with reducing the frequency of PNES and to travel independently. A staged approach using relaxation techniques and graded exposure was used and the frequency of PNES was significantly reduced and the individual was able to make several successful bus journeys.

Reference

Chaplin, E., Craig, T. and Bouras, N. (2012), “Using service user and clinical opinion to develop the SAINT; a guided self-help pack for adults with intellectual disability”, Advances in Mental Health and Intellectual Disability, Vol. 6 No. 1, pp. 17-25