Specialist Mental Health in Learning Disabilities Services

Specialist Mental Health in Learning Disabilities Services
In some areas across the UK specialist teams have been developed that specifically
focus on the mental health needs of people with learning disabilities
(sometimes referred to as MHiLD teams). These teams are multi-disciplinary
and based in the community.
The Mental Health in Learning Disabilities teams provide two major
functions: the first is a clinical function and the second is service related.
Clinically they provide specialist assessment and treatment, which may be
home based or at an out-patient clinic. On a service level they may provide
advice and consultation to other services and training, especially to care
staff.
One example of such a team is the specialist mental health in learning
disability service that operates in South East London. It has the same characteristics
as other specialist teams: a clear definition of the mental health
problems people with intellectual disabilities might have (based for example on diagnosis, age or gender); an explicit range of treatments; a
fixed capacity and well-clarified roles and responsibilities with high levels
of specialized training and skill among their staff team. People are referred
to this service from GPs or other community mental health teams.
The clinical team consists of psychiatrists and community psychiatric
nurses. It also works with clinical psychologists, challenging needs practitioners
(specializing mainly in behaviour analysis), occupational therapists,
speech therapists and social workers. This team works closely with
other local mental health services, local specialist intellectual disabilities
teams, and health and social care services. It provides out-patient clinics,
outreachwork, in-patient assessment and treatment, and consultation with
community agencies for people with intellectual disabilities and mental
health problems. It also provides training to care providers.
There are three phases in the provision of clinical services: structured
assessment, intervention and follow-up. Therapeutic interventions are
based on multi-disciplinary work and include biological interventions,
psychological interventions such as cognitive behavioural therapy and
social interventions such as making changes to the person’s environment
or social circumstances (see Chapter 4 on therapeutic interventions). Crisis
prevention plans are developed to help families and service providers
identify early signs of breakdown and to take appropriate action. Weekly
team meetings are held to review progress. Training is offered to families
and caregivers at this stage, to help them better understand and respond to
the mental health needs of people with intellectual disabilities. This may
take the form of seminars, books or videos, as well as modelling and
role-playing exercises. Ongoing support and consultation is also provided.
Follow-up is provided for as long as required. Once the person appears
stable and the agreed upon care plan seems effective the team maintains
quarterly or six-monthly contact.