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Mental ill health and intellectual disabilities-Role of care programme approach
- Lakshmiprabha Ramasubramanian, Dr.Ranasinghe,consultant psychiatrist,Learning disabilities (1 February 2007)
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Untitled
- Wael Foad (29 May 2007)
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Lakshmiprabha Ramasubramanian, senior house officer,learning disabilities 5 Boroughs partnership NHS Trust, Dr.Ranasinghe,consultant psychiatrist,Learning disabilities
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gautamprabha{at}aol.com Lakshmiprabha Ramasubramanian, et al.
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Dear Editors, Sally-Ann Cooper and colleagues have looked at prevalence of mental ill-health in adults with intellectual disabilities and the factors associated with it in a very comprehensive manner. The use of semistructured instruments and detailed individual assessments add to the quality of the study even though the study has got a few limitations that have been acknowledged. People with learning disabilities can present with complex behavioural ,emotional and mental health needs that are best understood within a biopsychosocial framework.. Comprehensive multidisciplinary and multimodal approach to assessment, care planning and case management is needed in meeting the mental health needs of this client group (O'Hara and Sperlinger, 1997) and the role of care programme approach is vital in acheiving this. Hence we did an audit of effective care coordination in Learning Disability across St.Helens and Knowsley Boroughs and looked the standard and enhanced care plans of all our patients on Care programme approach in December 2006.Even though Care programme in learning disability is complemented by health action plan and person centred plan,we found that if we address specific problems related to employment,housing,social environment and lifestyle in the care plans we could address the factors independently associated with mental illness in this population which the authors have highlighted in the discussion.Also Joint training for all the professionals involved in the CPA process will improve their understanding of specific clinical presentations of mental health problems in people with learning disability and help us derive the maximium benefit out of effective care coordination. Reference 1.Roy A et al.,The Care programme approach in learning disability psychiatry.Adv Psych Tr(2000)6;380-387 2.HigginsS et al.The mental health needs of people with severe learning disabilities.Br J Nurs.2004 Dec9-2005 Jan 12;13(22);1342-6 3.Valuing People: Moving forward together - The Government's annual report on learning disability 2004.Department of health. 4.Department of Health (1999a) A National Service Framework for Mental Health. London: DoH. Declaration of interest-none Dr.Lakshmiprabha Ramasubramanian.MRCPsych.Senior House Officer,Learning Disabilities. Willis House,23,cumber lane,whiston,Merseyside.L35 2YZ telephone:01514265885 Dr.Ranasinghe,Consultant Psychiatrist,Learning Disabilities. Willis House,23,cumber lane,whiston,Merseyside.L35 2YZ telephone:01514265885 |
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Wael Foad, SHO in learning disabilities Merseycare NHS trust
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wfoad{at}hotmail.co.uk Wael Foad
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Dear Editors, Cooper et al1 in their study of the prevalence of mental illness in adults with intellectual disabilities concluded that mental ill-health was associated with not having severe physical disability and not having immobility. However, I note from the data presented in table 4, that absence of severe physical disability/ quadriplegia and being fully mobile was not associated with mental illness, which is in contrast to the study’s conclusion. Clinical experience suggests that the presence of severe physical disability or immobility is associated with mental illness in our clients. Looking at the conclusion, it appears that there is some mismatch between the data from the table and the conclusion drawn by the authors. Declaration of interest-none. 1 Cooper, SA, Smiley E, Morrison J, Williamson A, Allan L, (2007) Br. J. Psychiatry, 190: 27 - 35 Dr Wael Foad. MB ChB, MRCPsych part 1. Senior House Officer, Learning Disabilities. 20 Crosby Road North, Liverpool L22 4QF. Telephone: 01519284107. Fax: 0151 928 6590. |
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