The British Journal of Psychiatry (2010) 196: 133-138. doi: 10.1192/bjp.bp.108.060939
© 2010 The Royal College of Psychiatrists
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Service use and cost of mental disorder in older adults with intellectual disability

Andre Strydom, MRCPsych, MSc, PhD

Department of Mental Health Sciences, University College London Medical School, and Camden and Islington Foundation NHS Trust, London

Renee Romeo, MSc

Centre for the Economics of Mental Health, King’s College London, Institute of Psychiatry

Natalia Perez-Achiaga, MRCPsych, MSc

Community Learning Disabilities Team, Royal Borough of Kensington and Chelsea, London

Gill Livingston, FRCPsych, MD

Department of Mental Health Sciences, University College London Medical School, and Camden and Islington Foundation NHS Trust, London

Michael King, MD, PhD, FRCP, FRCGP, FRCPsych

Department of Mental Health Sciences, University College London Medical School

Martin Knapp, PhD

Personal Social Services Research Unit, London School of Economics, and Centre for the Economics of Mental Health, King’s College London, Institute of Psychiatry

Angela Hassiotis, MA, PhD, FRCPsych

Department of Mental Health Sciences, University College London Medical School, and Camden and Islington Foundation NHS Trust, London, UK

Correspondence: Correspondence: Dr Andre Strydom, Department of Mental Health Sciences, University College London, 67–78 Riding House Street, London W1W 7EY, UK. Email: a.strydom{at}ucl.ac.uk

Declaration of interest

None.

Background

The cost of caring for people with intellectual disability currently makes up a large proportion of healthcare spending in western Europe, and may rise in line with the increasing numbers of people with intellectual disability now living to old age.

Aims

To report service use and costs of older people with intellectual disability and explore the influence of sociodemographic and illness-related determinants.

Method

We collected data on receipt and costs of accommodation, health and personal care, physical as well as mental illness, dementia, sensory impairment and disability in a representative sample of adults with intellectual disability aged 60 years and older (n = 212).

Results

The average weekly cost in GBP per older person was £790 (£41 080 per year). Accommodation accounted for 74%. Overall costs were highest for those living in congregate settings. Gender, intellectual disability severity, hearing impairment, physical disorder and mental illness had significant independent relationships with costs. Mental illness was associated with an additional weekly cost of £202.

Conclusions

Older adults with intellectual disability comprise about 0.15–0.25% of the population of England but consume up to 5% of the total personal care budget. Interventions that meet needs and might prove to be cost-effective should be sought.


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