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Mental health disorders in young people with learning disabilities still under-recognised and often untreated in clinical practice

John Northfield

In 2002, the Foundation for People with Learning Disabilities produced a landmark report on the issue of mental health and emotional well-being in young people with learning disabilities ‘Count Us In’, which looked at ways of supporting young people to be emotionally strong, through education, support, friendships and advocacy. The report followed a year long enquiry by the Foundation which identified a significant issue with mental health in young people.

Ten years on, these issues remain, and this review looked specifically at the evidence produced in the last 18 months to see what progress was being made in the identification of mental health issues and to look at what we are learning about effective interventions.

The authors found that further studies have been published which support earlier findings suggesting increased prevalence of mental health disorders in young people with learning disabilities. The recent articles suggest higher rates of co-morbidity than previously recognised.

They found few studies looking at the effectiveness of psychological and pharmacological treatments. The literature does identify though that pharmacological treatment appear to be routinely used and in some case inappropriately administered.

They found that antipsychotic medications were the most commonly prescribed medications despite the lack of evidence for their efficacy. They also appeared to be prescribed to address challenging behaviours rather than for identified psychiatric disorders.

They found some reviews looking at services and policies in other countries which suggests that this issue is beginning to receive attention internationally. They suggest that these reviews are also beginning to add to a shared vision of inclusive community based services.

They conclude that whilst the recently published studies add to an improved knowledge base on the rates of mental health disorders in young people with learning disabilities, that such mental health needs are still under-recognised in clinical practice and can remain untreated.

The mental health needs of children and adolescents with learning disabilities , Vedi, K & Bernard, S in Current Opinion in Psychiatry. 25(5):353-358,

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After qualifying as a social worker, John worked in community learning disability teams before getting involved in a number of long-stay hospital closure programmes, working to develop individual plans for people moving into their own homes. He worked for BILD, helping to develop the Quality Network and was editorial lead for the NHS electronic library learning disabilities specialist collection. This led him to found the Learning Disabilities Elf site with Andre Tomlin as a way of making the evidence accessible to practitioners in health and social care. Most recently he has worked as part of Mencap's national quality team and also been involved in a number of national website developments, including the General Medical Council's learning disabilities site.

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  • Pauline Thomas

    Pauline Thomas

    13 years ago
    I would like agree with Joanne regarding the training of support staff helping people to attend school or other services. They need to learn when to help or when to step back. My son has been away from day services for over two years now, but before he developed his anxiety he attended a social business outsourced by our local council and the staff there were for ever telling him he needed a 1-1 but he was adamant that he wanted to be independent. They wore him down in the end and he left. The irony of all this is that the company gained the contract with the mantra that they were going to help people with LD to be more independent! As regards to young people and adolescents with mental health issues, you have to look at the way 'services' are often offered to these people. For a start there is a wide belief among service providers that these people do not feel deeply enough to ever get hurt or upset. When they do show signs of depression, and it can be narrowed down to the way they are being treated, no one in the mental health team seems to want to challenge the service providers, but instead turn to medication to 'fix' the problem. Mental Health providers should and could be a voice for these 'powerless ones' if only they were given the power to challenge local authority policies regarding the provision of decent services.
    • 1 reply
    • John Northfield
      John Northfield 13 years ago
      Thanks for your comments, I think you are absolutely right about the need for training for support staff, but I also think this needs to be supported by good practice leadership to enable staff to be supported t put what they are learning in training into practice and to reflect on this.
  • Joanne Heeney

    Joanne Heeney

    13 years ago
    I have a son with ASD attending mainstream school. There is a huge need for training in the social model of disability for school staff. Often what staff misguidedly assume is suportive for the child actually disempowers and disables, leading to loss of confidence and self esteem. There needs to be a huge cultural shift with regard to SEN. Only through losing the deficit tag and exploring the diversity of human nature can we help to improve long term outcomes for these children.