Mental health issues and adults with learning disabilities

Full text of this book chapter is not available in the UHRA.Introduction – What is a mental health condition? How does this differ from a learning disability? Prevalence and aetiology of mental illness in people with learning disabilities – Why is their high numbers of people with learning disabilities and associated mental health problems? Assessment and Diagnosis – How are people with learning disabilities assessed for mental illness? Problems of assessing people with LD. Service Provision – A look at how people with learning disabilities and mental health needs have in the past and are presently being cared for. Therapeutic Interventions – Medication and non-physical interventions aimed at addressing the needs

People with learning disabilities and mental health problems: the impact of ethnicity

There is increasing awareness of the needs of people with learning disabilities from different ethnic communities. This paper focuses on the impact of ethnicity on the presentation of mental health problems. The main aim of the paper is to inform those planning and delivering mental health services for people with learning disabilities of the current evidence, in order to enable their practice to improve health outcomes for people from minority ethnic communitie

Contractual Incapacity and the Americans with Disabilities Act

The doctrine of contractual incapacity allows people with mental disabilities to avoid their contractual liability. Its underlying premise is that the law has an obligation to protect people with such disabilities both from themselves and from unscrupulous people who would take advantage of them; mental incapacity provides this protection by rendering certain contracts unenforceable. The Disability Rights Movement (“DRM”), however, has challenged such protective legal doctrines, as they rest on outmoded concepts about people with mental disabilities. This essay argues that the mental incapacity doctrine undermines the goals of the DRM and the legislative goals of the Americans with Disabilities Act. First, the doctrine reinforces stereotypes about people with mental disabilities, contributing to the negative social construction of disability. Second, it contributes to the social exclusion of people with mental disabilities, as the threat of contract rescission discourages commerce with people with mental disabilities. Third, the doctrine unjustifiably imposes a requirement of rationality upon transactions entered into by people with mental disabilities. Finally, the doctrine demeans people with disabilities by shielding them from the risk-taking that is an integral part of life. To mitigate the harm caused by contractual incapacity I propose that the doctrine be restricted to people who were subject to a plenary guardianship when they entered into the contract. Such a restriction is an imperfect proposal, but it strikes a better balance between the rights of people with mental disabilities and the mental incapacity doctrine than currently exists

Social entrepreneurship and employment challenges of persons with mental disabilities

In developed countries there is a valuable experience how to include people with disabilities into society: involve in several activities and let them know as people valuable for the society. More and more academic research is devoted to those aspects as well as public policy is developed to create and support social entrepreneurship. Aim of the paper is to analyse findings and good practice of employment of people with mental disabilities in several countries and analyse the situation and possible developments on employment of people with mental disabilities in Latvia. Tasks of research: 1) analyse results of academic findings on good practice and challenges in employment of people with mental disabilities wold-wide; 2) analyse the developments and trends on employment of people with mental disabilities in Latvia; 3) propose possible development scenarios on employment of people with mental disabilities in Latvia. Research methods used in research: scientific publications analysis; analysis of legislative documents on employment of people with mental disabilities, analysis of statistical data on employment of people with mental disabilities. Research results have shown that in recent years many important steps in employment of people with mental disabilities in Latvia has been reached but there are some difficulties in realise of sustainability in this aspect

Left Out Of The Economy: Much More Must Be Done to Help Consumers Enter the Workforce

[Excerpt] Unemployment leads directly to poverty— a situation that people with mental illness are three times more likely to be in than people without disabilities. Cornell University researchers reported in 2005 that people with psychiatric disabilities had a poverty rate of 30% compared to 24% for people with any disability and 9.1% for people without disabilities. Few things are more harmful to a person\u27s physical and mental health than long-term unemployment. Numerous studies within the past two decades show significant correlations between long-term unemployment and negative personal results, such as increased hospitalizations, increased substance abuse, greater incidence of depression, lower self-esteem, and increased anxiety. So it is quite surprising that so much discussion centers around the possible negative effects of stressors associated with entering employment (with little evidence supporting this view). There is almost no discussion on the need to avoid long-term unemployment

Nothing About Us Without Us: Combining Professional Knowledge with Service User Experience in Training about Mental Health and Learning Disabilities

Recent policy documents relating to people with learning disabilities have proposed that they be more fully included in generic mental health care provision. In practice such inclusion has been slow to proceed, hampered by factors which appear to include lack of knowledge and confidence on the part of generic mental health practitioners. Policy documents have also recommended training of practitioners by people with learning disabilities, which has been found to impact positively on confidence and attitudes. This study reports on a training session delivered to ‘Improving Access to Psychological Therapies’ practitioners by a service user with learning disabilities who has accessed mental health services, together with a clinical psychologist and an honorary assistant psychologist. The practitioners were asked to rate their knowledge about and confidence in working with people with learning disabilities before and after the training. Participants rated themselves as having significantly greater knowledge and confidence following the training, and many of the qualitative reasons given for these changes mentioned the contribution of the service user. This paper includes details of her particular contribution to the training, together with her reflections on the experience of joint training, given in an interview with the assistant psychologist. It is concluded that joint training needs to be developed and its impact further researched

CBT for people with intellectual disabilities : emerging evidence, cognitive ability and IQ effects

Historically people with intellectual disabilities have not been offered or received cognitive behavioural interventions that have been shown to be effective for mental health and emotional problems experienced by those without such disabilities. This is despite many people with intellectual disabilities having life experiences that potentially result in them having an increased risk to such problems. This paper discusses whether such therapeutic disdain is justified based on the evidence that is available and emerging concerning the application of cognitive behavioural interventions for this population. Issues concerning access to services, the ability of people with intellectual disabilities to engage in and benefit from the cognitive components of CBT, and the effect of cognitive abilities and IQ level on treatment effectiveness are explored in relation to this question

The ADA Amendments Act of 2008

The goal of the Americans with Disabilities Act (ADA) was to create a civil rights law protecting people with disabilities from discrimination on the basis of their disabilities. Disability rights advocates in 1990 were victorious in their efforts to open doors for people with disabilities and to change the country\u27s outlook and acceptance of people with disabilities. These advocates believed that the terms of the ADA, based as they were on Section 504 of the Rehabilitation Act, combined with the legislative history of the ADA, would provide clear instructions to the courts that the ADA was intended to provide broad coverage prohibiting discrimination against people with a wide range of physical and mental impairments. Unfortunately, the Supreme Court--with lower courts following in its lead, barricaded the door that the ADA had opened by interpreting the definition of disability in the ADA to create an overly demanding standard for coverage under the law. This article provides an overview of the advocacy effort that has resulted in restoring the original intent of the ADA and destroying the barriers of discrimination that prevent people with disabilities from fully participating in society

Estia Centre 10 Years

In 2009, the Estia Centre celebrates a decade of working \ud towards making sure the mental health needs of people \ud with learning disabilities are met – through specialist \ud clinical services, research, and a programme of training \ud and education for both support workers and mental \ud health professionals. \ud \ud Despite government efforts of recent years, people \ud with learning disabilities are still marginalised. Those \ud with mental health problems and more complex needs \ud are even more socially excluded: they are much less likely \ud to be given the chance to speak for themselves and much \ud less likely to be given choices. Many people with learning \ud disabilities and mental health problems are placed in \ud residential or specialist treatment centres far from their \ud local community: historical lack of state investment has \ud led to a growth of independent providers of services \ud and a dearth of specialist public sector alternatives. \ud Based on Guy’s Hospital campus at London Bridge, the \ud Estia Centre is part of South London and Maudsley NHS \ud Foundation Trust (SLaM). Members of the Estia team work \ud in SLaM’s clinical services and at the Institute of Psychiatry \ud (IoP),King’s College London, SLaM’s academic partner. \ud There is also a dedicated team at the Centre responsible \ud for organising a large portfolio of training, offered \ud routinely to staff in social care and mental health services \ud in south London, and also available on request to staff \ud working in services around the UKand in other countries. \ud \ud The work of the Estia Centre has been inspirational to \ud clinicians and policy makers around the world. Over the \ud years, the Estia team has shared skills and experience \ud through long-standing collaborations and consultancy \ud work, helping to shape and develop specialist mental \ud health services for the benefit of people with learning \ud disabilities and their families

The right to legal capacity in Kenya

The report highlights the voices of people with mental disabilities themselves for the first time, outlining the need for substantial legal and social reform, and provides comprehensive recommendations to bring Kenya in line with international law, and specifically right to legal capacity guaranteed by Article 12 of the UN Convention on the Rights of Persons with Disabilities (CRPD)