The organisation of mental health services for people with learning disabilities, particularly issues relating to inpatient care remains an important area for research. This review of the literature set out to identify recent findings.
The review found that people with learning disabilities appeared to be admitted with more severe problems and also received more interventions than those without learning disabilities when they were admitted to general psychiatric units.
There has also been qualitative research which has suggested that some general psychiatric inpatient units have provided poor standards of care when treating people with learning disabilities and mental health problems.
Where treatment in supported generic inpatient units has taken place, studies have reported successful outcomes for people and qualitative studies of patient satisfaction have also shown good levels of satisfaction.
Regarding issues of length of stay and discharge, recent studies have suggested that the length of stay for people with LD has not been longer on specialist rather than general psychiatric units, but delayed discharge and restrictive practices have continued to cause difficulties.
There have been evaluations of the important components of community mental health services and these have taken into account the views of a number of stakeholders, including psychiatrists, people with disabilities and carers. These evaluations have suggested that emergency provision of psychiatric assessment and emergency care continued to be a problem in a number of areas.
The author concludes that service evaluations have suggested positive outcomes in specialist services, but that these have been comparisons made without experimental controls. He points out that there is a significant lack of randomised controlled trials in the field, but that qualitative work has enabled clinicians to have access to a body of knowledge about the nature of patients’ and carers’ experiences of mental health services.
He recommends further research on the measurements of outcome and patient satisfaction.
Mental health services for people with intellectual disabilities, Chaplin, R, in Current Opinion in Psychiatry, 24, 5, 372–376