Key themes for development of community mental health services for people with learning disabilities


The evidence on prevalence of mental health issues in people with learning disabilities is subject to some debate, as a result of methodological issues in the published studies. Despite these difficulties, there is agreement that the prevalence of mental health problems in this group is high.

There continues to be debate over the appropriateness of admissions of people with learning disabilities to mainstream mental health services, with some suggestion that specialist services alone have the necessary skills and resources to provide appropriate support. However there are insufficient specialist learning disability services to meet the volume of demand. Specialist services are not always locally available, leading to people being placed away from their regular communities of  support.

The authors of this paper set out to enrich this debate by gathering the views of 14 multidisciplinary professionals from specialist learning disabilities services. They interviewed these specialists to gather their opinions on four key areas of community service provision.

  • review and monitoring of people who used the services
  • access to social, leisure and occupational activities,
  • support, advice and training for a person’s family or carers
  • “out of hours” and crisis responses

They coded the data and then analysed them thematically, hoping to identify the key service components and how these could be best developed and delivered.

What they found was that the discussion opened up further areas of importance, developing ten major emergent themes

  • configuration/structure
  • clarity of purpose/care pathways
  • joint working
  • training
  • flexibility
  • resources
  • evidence-base
  • holistic/multidisciplinary approach
  • needs-led/personalisation
  • accessible information

They suggest that these findings should enable further research for the development and evaluation of services

Expert opinions on community services for people with intellectual disabilities and mental health problems, Hemmings C and Al-Sheikh A in Advances in Mental Health and Intellectual Disabilities, 7, 3, 169 – 174

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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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