Search results

This study aims to explore the experiences of people with intellectual disabilities in Singapore receiving inpatient mental health treatment. To date, there has not been any research that examines the views and experiences of this population in Singapore. The research examines how the participants view their mental health problems and their experiences of the services they received.

A qualitative design was chosen to address the research question. Six adult men with intellectual disabilities were recruited from the tertiary hospital and interviewed. The transcripts of these interviews were analysed using interpretative phenomenological analysis.

Four super-ordinate themes were identified; awareness of mental health problems; yearn for a life outside the ward; interacting with other people and finding purpose.

The participants reported that they struggled with being segregated from their families and communities following an inpatient admission. They were able to report on the emotional difficulties that they experienced and hoped to find employment after their discharge from the hospital. They talked about reconstructing their self-identity and forming friendships to cope with their hospital stay. This research is one of its kind carried out in a non-western society and the findings are discussed in the light of how mental health professionals can best support people with intellectual disabilities during their inpatient treatment.

Trauma-focussed cognitive-behaviour therapy (TF-CBT) is the most effective treatment for post-traumatic stress disorder (PTSD). Individuals who present with complex PTSD are among the most complex and challenging patients seen by intellectual disability psychology and psychiatry services. The purpose of this paper is to study TF-CBT intervention for people with intellectual disabilities and complex PTSD.

Three groups of adults with intellectual disabilities (ID) presenting with complex PTSD (n=3, n=5 and n=4) were treated using a 12-week manualised intervention adapted from a procedure routinely used in adult mental health services. Participants completed the Impact of Event Scale as adapted for people with intellectual disabilities (IES-ID) before and after the intervention, and interviews conducted to ascertain their experiences of the group were analysed using interpretative phenomenological analysis (IPA).

The ten participants who completed the intervention showed a 27 per cent decrease in median Impact of Event Scale Intellectual Disabilities scores, equivalent to a medium effect size (d=0.50). Five themes were identified from the interviews: being listened to; it is nice to know you are not the only one; being in a group can be stressful; the importance of feeling safe; achieving and maintaining change. Participants also provided constructive feedback to promote improvements to the manual.

A feasibility study followed by methodologically robust clinical trials is now needed to establish the effectiveness of the intervention and its utility in clinical practice.

This small study has confirmed the potential of TF-CBT as an intervention for extremely vulnerable individuals with ID who present with complex PTSD.

The findings indicate that a group intervention is both feasible for and acceptable to adults with ID.

To date, no study has investigated the effectiveness and feasibility of a TF-CBT group intervention for adults with mild ID.

It has been recommended that social, health and other relevant professionals work collaboratively to support parents with learning disabilities (LD) and their children. A number of qualitative studies have investigated the experiences of professionals who work with parents with LD. A synthesis of these experiences has not as yet been produced, and therefore, the purpose of this paper is to review how professionals experience working with parents with LD to inform practice guidelines on how parents with LD can be supported most effectively.

A systematic search took place using five databases and 15 peer-reviewed papers were identified based on the relevant inclusion and exclusion criteria. The quality of each included paper was systematically evaluated. Meta-ethnography was used to synthesise the qualitative data from the identified studies.

The synthesis offered six themes: concerns about knowledge and experience, the importance of and difficulties with available support, the importance of and challenges with liaison with and between professionals, differences in power, conflicting priorities – parents or children?, the personal impact on professionals.

The results are discussed in the context of previous research. Recommendations for future research and practice innovation are made.

In recent years, group interventions have been designed to simultaneously treat the symptoms of post-traumatic stress disorder (PTSD) and substance misuse. This study aims to explore the research literature available regarding these interventions, for women who are involved in the criminal justice system.

Five electronic databases were searched. The review included primary research papers which reported quantitative outcomes for group interventions for female offenders. The quality of each paper was assessed using the framework developed by Kmet et al. (2004).

A total of 13 research papers met the inclusion criteria and were selected for this review. The papers indicated promising results for the treatment of PTSD and substance misuse in this population group.

This area of research is in early development. Studies adopted different research designs and used different outcome measures to assess effectiveness. The quality assessment indicated that future research should adopt standardised assessment measures, blind researchers to reduce bias and implement randomised controlled trials to produce more robust findings.

To the best of the authors’ knowledge, this systematic review is the first to explore the effectiveness of these interventions, specifically for women in the criminal justice system. The authors consider the existing evidence base for this population group and propose measures for future research.

Heslop, Folkes and Roger's article about the knowledge and experiences of people with learning disabilities and their carers of psychiatric drugs, and Lim's audit of prescription regimes in a hospital for people with severe learning disabilities in Hong Kong, add weight and substance to a substantial body of evidence which suggests that people with learning disabilities are often prescribed inappropriate, and at times excessive, amounts of psychotropic medication and that many staff/carers lack sufficient knowledge and skills to monitor and manage such medications (Singh et al, 1996). A number of years ago we wrote a review of the use of psychotropic drugs for people with learning disabilities (Stenfert Kroese et al, 2001) which included a number of recommendations. The Heslop et al and Lim papers bring up many issues which were relevant to these recommendations.

Research into the views of people with dual intellectual and mental health difficulties is sparse. The purpose of this paper is to gain a greater understanding of how individuals with mild intellectual disabilities living in the community understand their psychotic symptoms and experiences.

Five participants with intellectual disabilities and psychotic symptoms living in the community were interviewed. The interview schedule explored key areas: understanding and experiences of having an intellectual disability and a psychotic disorder, and of services provided. The data were analysed using Interpretative Phenomenological Analysis.

The analysis elicited three main themes: self-concept: “How I understand and see myself”, incorporates what participants understood about their labels, their experiences, and how these labels fitted in with their self-concept; Impact: “How having mental health problems and learning difficulties affect my life”, encompasses communication barriers, lack of control, and stigma and vulnerability. The third main theme was coping: “How I cope with my mental health and learning difficulties”.

The findings suggest that the participants, rather than identifying with specific psychiatric labels perceive themselves as having individual and specific needs. The analysis highlights areas that can be developed to help with coping; ensuring people are respected and heard, empowerment through the development of positive social roles, and psycho-education. These results are a step towards developing understanding of this group of service users.

There has been no previous research into the perspective of this service user group in the community. The study makes recommendations for future person-centred interventions.

The purpose of this qualitative study was to investigate how the proceedings of a vulnerable adult protection policy is understood by referrers to affect the psychological and emotional well‐being of adults with a learning disability. During the research process seven referrers of vulnerable adults discussed twelve different cases in in‐depth interviews. The interviews and matching case notes of protection meetings released by social services were analysed by the application of grounded theory techniques. The result is a model that highlights how appraisals of the experience the emotional and behavioural reactions of the vulnerable adults are shaped by the nature of the abuse, the actions taken by protection meetings, the expectations of the vulnerable adults and the availability of support.

While an increasing number of adults with an intellectual disability are having children, research suggests that they face an increased risk of having their children removed. The purpose of this paper is to explore child and family social workers’ experiences of working with parents with intellectual disability, in order to further our understanding of this issue.

Seven social workers were interviewed. Each had experience of working on safeguarding cases where a parent had a diagnosis of intellectual disability. Data were analyzed using Interpretive Phenomenological Analysis.

Five super-ordinate themes were identified. These were: “feeling torn,” “experiencing a power imbalance,” “hopelessness,” having “pride” in their work’ and experiencing “barriers.”

The results are discussed in the context of the increased risk that parents with an intellectual disability face of having their children removed. Several areas for future research are identified.

The study highlights several areas for development regarding services for parents with intellectual disability.

The study describes some of the difficulties experienced by social workers in this area of their work, from their own perspective. It also strengthens existing ideas about improving services for parents with intellectual disability.

The current qualitative study aims to investigate 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.

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.

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.

A number of suggestions for improving services are discussed in the context of the current findings.

The purpose of this paper is to investigate how service managers perceive their service prior to, and following the delivery of a cognitive-behavioural therapy (CBT) anger management group for individuals with an intellectual disability.

Telephone interviews were conducted with seven service managers, before and after a CBT group intervention. The interviews were recorded, transcribed and analysed using thematic analysis to identify common and/or contrasting themes.

Before the intervention took place managers observed a lack of consistency in how their staff dealt with challenging incidents and the serious consequences these incidents had for service users as well as staff. They spoke about the importance of multi-disciplinary working and good quality staff selection, support and training. After the group intervention managers commented on a positive “spilling-out effect” whereby the whole organisation was influenced by the intervention, a greater willingness on the part of service users to talk about their problems, and an increased confidence in the staff members who had co-facilitated the group work.

The implications of the themes raised are discussed and recommendations for further research are suggested.

This research provides a unique contribution of managers’ views and insight into how hosting a CBT group intervention impacted on their wider services.