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We report a case of a person with Down's syndrome presenting with symptoms of depression and symptoms of an atypical eating disorder. Significant challenges and dilemmas were encountered during his assessment and treatment. Twenty years ago he had presented in a similar way and his lengthy but successful treatment was published. We will present his case in two parts. The first will cover his clinical presentation and assessment and the second will focus solely on his treatment. During the time of his assessment and management the Mental Capacity Act 2005 had just been introduced in England and Wales and the implications of this new legislation in the management of such cases will also be discussed.

The purpose of this paper is to be the first known case report of a patient with mild intellectual disabilities who has a novel partial trisomy of the long arm of Chromosome 6 (6q25.3→q26).

The patient's history and diagnosis are discussed.

This case highlights the importance of cytogenetic studies in the systematic evaluation of people with intellectual disabilities and co‐morbid psychiatric conditions.

Performing detailed chromosome analysis by array comparative hybridisation on patients with unexplained intellectual disabilities and mental health problems may enable an underlying diagnosis to be identified.

There is ongoing discussion around how to structure psychiatric services to meet the needs of people with intellectual disability and co‐morbid mental illness and several different models have been suggested. With research evidence lacking, there is a lack of consensus as to the best model of service provision. This paper aims to review the current knowledge in this area and discuss the salient issues.

This is a review article summarising the current debate. Evidence from original research is presented and combined with opinion from clinical experience.

The authors find a lack of robust research evidence to support any particular model of service provision. However, it seems to be increasingly accepted that purely generic models of care for people with intellectual disabilities and co‐morbid mental illness are not appropriate. Integration of the expertise from specialist services within mainstream services is presented as potentially the most advantageous approach.

This article will be of benefit to clinicians working in the field of intellectual disability and mental illness, and to managers and commissioners with responsibility for providing services. It will also be useful for those new to the discipline to gain an overview of the current issues and debate within service planning for this population.

Over 1,250 people with intellectual disabilities die unnecessarily every year in NHS care. The purpose of this paper is to develop higher-order learning amongst medical students to increase engagement with this disadvantaged group and redress this injustice in care provision.

The Psychiatry of Intellectual Disability input to University College London's (UCL) undergraduate medicine MBBS curriculum was re-designed. Materials were developed to broaden the students’ understanding of the stigma and health implication of intellectual disability and the affect it has on the care received by these patients. These were delivered in lecture and e-learning formats. The concept of psychological capital was used to frame the development of new materials with direct involvement of service users with intellectual disability. It is a management model designed to promote higher levels of learning, resulting in a deeper understanding of patient issues by UCL medical graduates.

Findings from the online survey that accompanies the e-learning materials suggests that students have overwhelmingly adopted a positive outlook towards patients with intellectual disability and consider training necessary for all doctors. The filmed scenarios with people with intellectual disability appealed to students.

The broadening of the educational materials required a re-design of the methods of curriculum delivery, a higher level of self-directed learning and student time commitment. Further assessments of the impact of the module are planned to include formative assessments of learning.

Medical lack of knowledge, personal attitudes and a reluctance to engage with people with intellectual disability have been identified as barriers to their receiving appropriate care.

A blend of organisational change theories has been integrated into the production of a new, multi-media, e-learning package.