Is expertise from specialist services in mainstream services best way to support people with learning disabilities and mental health needs?

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The recently published guidance from the joint commissioning panel for mental health suggested that ‘there is no universally agreed commissioning model for mental health services supporting people with learning disabilities’ and this reflects an on-going debate about the structure and delivery of services to meet the needs of this group.

The commissioning guidance suggests that learning disability services should be provided alongside mainstream mental health services so that the skills and expertise from both services can be utilised in order to respond to individual need

The aim of this paper was to summarise the debate in the context of a lack of clear evidence base. The authors searched the published literature and were able to confirm that there is a distinct lack of any robust research evidence to support the view that any particular model of service provision was more effective than any other.

The papers they found did provide some support to the view that specialist services did have the necessary skills and resources to provide support, but that such services were not always available.

In addition they found, in agreement with the commissioning guidance, that there is now an accepted view that the provision of generic models of care for people with learning disabilities and co-morbid mental illness were not appropriate. They suggest therefore that the prevailing view is now for the integration of expertise from specialist services into mainstream services.

A comparison of different models to meet the mental health needs of adults with intellectual disabilities, Sheehan R & Paschos D, in Advances in Mental Health and Intellectual Disabilities, 7, 3, 161 – 168

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John Northfield

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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