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3 - Inter-disciplinary multi-modal assessment for mental health problems in people with intellectual disabilities

from Part I - Assessment and diagnosis

Published online by Cambridge University Press:  15 December 2009

Jean O'hara
Affiliation:
Consultant Psychiatrist, York Clinic, Guy's Hospital, London
Nick Bouras
Affiliation:
King's College London
Geraldine Holt
Affiliation:
King's College London
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Summary

Introduction

The advantages of a co-ordinated, inter-disciplinary approach to the assessment, diagnosis, treatment and management of mental health problems in individuals with intellectual disabilities (ID) are generally accepted. However, the degree of co-ordination, and the timeliness of assessments and interventions can make it difficult to pull the various strands of information together. Without this co-ordination and overview, the histories of individuals with ID tend to remain fragmented, lost and forgotten. This may then be perpetuated by poorly documented clinical notes, incomplete personal, social and treatment histories, inadequate mental state and physical state examinations or investigations, and minimal attempts to document an understanding of why a person is presenting with a particular set of problems or needs, at a particular time in their lives.

The theory and research evidence behind assessment of mental health, self-injurious behaviours, challenging needs and the importance of excluding underlying physical health problems are covered elsewhere in this volume (see Chapters 5 by Lennox, 7 by Stavrakaki and Lunsky, 8 by Clarke, 9 by Lindsay, 13 by Saulnier and Volkmar, 14 by Hillery and Dodd, 10 by Cooper and Holland and 11 by Murphy and Mason). Diagnostic criteria, rating scales and interview schedules are also covered elsewhere (see Chapter 2 by Mohr and Costello). A comprehensive review of rating instruments can also be found in Lecavalier & Aman (2005). This chapter focuses on the practical approach to inter-disciplinary, multi-modal mental health assessments of individuals with ID.

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References

Ambalu, S. (1997). Communication. In Adults with Learning Disabilities: A Practical Approach for Health Professionals, ed. O'Hara, J. & Sperlinger, A., Chapter 4, pp. 45–60. Chichester: John Wiley & Sons.
Bradley, E. & Lofchy, J. (2005). Learning disability in the accident and emergency department. Advances in Psychiatric Treatment, 11, 45–57.Google Scholar
Campbell, H., Hotchkiss, R., Bradshaw, N. & Porteus, M. (1998). Integrated Care Pathways. British Medical Journal, 316 (7125), 133–7.Google Scholar
Charlot, L. and Silka, V. R. (2001). Creating a continuum of intensive psychiatric services for individuals with dual diagnosis: a perspective on the Massachusetts Experience. III. Inpatient psychiatric care. The National Association for the Dually Diagnosed Bulletin, Jan/Feb Vol. 4 No. 1, 7–9.Google Scholar
Cooper, S. A. (1997). Epidemiology of psychiatric disorders in elderly compared to younger adults with learning disabilities. British Journal of Psychiatry, 170, 375–80.Google Scholar
Day, K. (1992). Mental health care for the mentally handicapped in four European countries: The argument for specialized services. Italian Journal of Intellectual Impairment, 5, 3–11.Google Scholar
Deb, S., Matthews, T., Holt, G. & Bouras, N. (2001). Practice Guidelines for the Assessment and Diagnosis of Mental Health Problems in Adults with Intellectual Disability. Brighton: Pavilion.
Edgerton, R. B. (1967). Cloak of competence: stigma in the lives of the mentally retarded. Berkeley, CA: University of California.
Einfeld, S. L. (2001). Systematic management approach to pharmacotherapy for people with learning disabilities. Advances in Psychiatric Treatment, 7, 43–9.Google Scholar
Gardner, W. I., Graeber-Whalen, J. L. & Ford, D. R. (2001). Behavioral therapies: individualizing interventions through treatment formulations. In Treating Mental Illness and Behavior Disorders in Children and Adults with Mental Retardation, ed. Dosen, A. and Day, K.. Washington, DC: American Psychiatric Press Inc.
Gardner, W. I. & Sovner, R. (1994). Self-injurious behaviours, diagnosis, and treatment: a multimodal approach. Willow Street, PA: VIDA Publishing.
Goldberg, D. & Huxley, P. (1980). Mental Illness in the Community. London: Tavistock Publications.
Hastings, R. P., Hatton, C., Taylor, J. L.et al. (2004). Life events and psychiatric symptoms in adults with ID. Journal of Intellectual Disability Research, 48, 42–6.Google Scholar
Hollins, S. & Esterhuyzen, A. (1997). Bereavement and grief in adults with learning disabilities. British Journal of Psychiatry, 170, 497–501.Google Scholar
Hurley, A. D., Levitas, A., Lecavalier, L., Pary, R. J. & King, B. H. (in press). Assessment and diagnostic procedures. In Fletcher, R. J., Loschen, E. & Sturmey, P. (eds.), Diagnostic Manual for the Dually Diagnosed. Kingston, NY: National Association for the Dually Diagnosed Press.
Kendell, R. E. (1973). Psychiatric diagnoses: a study of how they are made. British Journal of Psychiatry, 122, 437–45.Google Scholar
King, B. H., Szymanski, L. S. & Weisblatt, S. (1995). Psychiatry and Mental Retardation: A Curriculum. Washington, DC: American Psychiatric Association.
Lecavalier, L. & Aman, M. G. (2005). Rating instruments. In Matson, J. L.Laud, R. B. & Matson, M. L. (eds.), Behaviour Modification for Persons with Developmental Disabilities: Empirically Supported Treatments. Vol. 1, pp. 160–89. Kingston, NH: National Association for the Dually Diagnosed Press.
Moss, S. (1999). Assessment: conceptual issues. In Psychiatric and Behavioural Disorders in Developmental Disabilities and Mental Retardation, ed. Bouras, N.. Chapter 2, pp. 18–37. Cambridge: Cambridge University Press.
Moss, S., Bouras, N. & Holt, G. (2000). Mental health services for people with intellectual disability: a conceptual framework. Journal of Intellectual Disability Research, 44, 97–107.Google Scholar
Moss, S. C., Patel, P. & Prosser, H.et al. (1993). Psychiatric morbidity in older people with moderate and severe learning disability (mental retardation). Part I: Development and reliability of the patient interview (the PAS-ADD). British Journal of Psychiatry, 163, 471–80.Google Scholar
NHS Scotland (2004). People with Learning Disabilities in Scotland: Health Needs Assessment Report. Glasgow: NHS Health Scotland.
O'Hara, J. (1989). Pregnancy in a severely mentally handicapped adult. Journal of Medical Ethics, 15, 197–99.Google Scholar
Ohayon, M. M. (2000). Prevalence of hallucinations and their pathological associations in the general population. Psychiatry Research, 97 (2–3), 153–64.Google Scholar
Ouellette-Kuntz, H., Garcia, N., Lewis, S.et al. (2004). Addressing health disparities through promoting equity for individuals with intellectual disability. Canadian Institute of Health Research. Kingston, Canada: Queen's University.
Perry, J. (2004). Interviewing people with intellectual disabilities. In Emerson, E., Hatton, C., Thompson, T. and Parmenter, T. R. (eds.), The International Handbook of Applied Research in Intellectual Disabilities, pp. 116–31. New York, NY: John Wiley & Sons Inc.
Reiss, S. & Aman, M. G. (1998). Psychotropic Medication and Developmental Disabilities: The International Consensus Handbook. Worthington, OH: IDS Publishing.
Reiss, S., Levitan, G. W. & Szysko, J. (1982) Emotional disturbance and mental retardation: Diagnostic overshadowing. American Journal of Mental Deficiency, 86, 567–74.Google Scholar
Ruedrich, R. L. & Hurley, A. D. (2001), Expert consensus guideline series: Treatment of psychiatric and behavioural problems in mental retardation. American Journal of Mental Retardation, 105, 159–228.Google Scholar
Rush, A. J. & Frances, A. (eds.) (2000). Editors: Expert consensus guideline series: treatment of psychiatric and behavioural problems in mental retardation. American Journal of Mental Retardation (special issue), 105, 159–228.Google Scholar
Sequeira, H. & Hollins, S. (2003). Clinical effects of sexual abuse on people with learning disability: critical literature review. British Journal of Psychiatry, 183, 13–19.Google Scholar
Smiley, E. (2005). Epidemiology of mental health problems in adults with learning disability: an update. Advances in Psychiatric Treatment, 11, 214–222.Google Scholar
Sovner, R. (1986). Limiting factors in the use of DSM-III criteria with mentally ill/mentally retarded persons. Psychopharmacology Bulletin, 22, 1055–9.Google Scholar
Tassé, M. J., Schalock, R., Thompson, J. R. & Wehmeyer, M. (2005). Guidelines for interviewing people with disabilities: Supports Intensity Scale. Washington, DC: American Association on Mental Retardation.
U.S. Public Health Service (2001). Closing the Gap: A National Blueprint for Improving the Health of Individual with Mental Retardation. Report of the Surgeon General's Conference on Health Disparities and Mental Retardation. Washington, DC.

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