Academic literature on the topic 'Residential psychiatric disability support service'

Intellectual disability is defined by the World Health Organization (WHO) as: ‘a significantly reduced ability to understand new or complex infor­mation and to learn and apply new skills (impaired intelligence) resulting in a reduced ability to cope independently (impaired social functioning)’, and begins before adulthood, with a lasting effect on development. People with an intellectual disability can develop any of the mental ill­nesses common to the general population; however, they are up to three times more likely to develop a mental illness. This predisposition to psy­chiatric illness can occur due to a variety of reasons, including associated genetic syndromes, brain injury, and sensory impairments. People with an intellectual disability are also more likely to have negative psychoso­cial experiences, such as deprivation, abuse, separation/loss events, low self-esteem, and financial disadvantage, and consequently the ensuing effects of these can affect their mental health. The psychiatric assessment of a person with an intellectual disability broadly covers the same as that of the general population; however, a different approach at times is needed to adapt to the individual’s com­munication skills. It may be necessary to complete history taking from a family member or carer, and an MSE may even have to be completed solely on observable behaviours. It is also more pertinent to focus on any co-existing medical conditions, such as epilepsy which is present in 25–30% of people with an intellectual disability. The WHO states that the true prevalence of intellectual disability is close to 3%. The vast majority of these people (85%) have mild intel­lectual disability defined as an IQ of 50–69 points. Many of these peo­ple can and do access mainstream services (with or without additional support). In whichever service you work, doctors and medical students will encounter people with intellectual disabilities, and an awareness of their needs is essential.

Having a child with intellectual disability is a major and usually totally unexpected blow to any family. However, most families show great resourcefulness and adapt to give their normal child as well as themselves a happy, rewarding life. Parents strongly resent being treated as potential psychiatric patients and have vigorously thrown out the concept of ‘the handicapped family’. They do suffer understandable grief. From the point of discharge, the encouragement of informal support is more useful than providing hospital-based services. Children with all sorts of disability go to school early and the provision of unobtrusive familiar services is helpful. Unfortunately, there is often a gap in services between children's services and those for older adolescents and adults. The gap occurs at the worst time for parents who of all times require a familiar knowledgeable person who can offer a service throughout the transition period. The services required by the parents are practical help, such as appropriate equipment, respite care, advice about behaviour, and the ability to find emergency or specialized help at short notice. Parents also require some notice to be taken of their increasing age and/or infirmity, the financial difficulties arising out of the disability, and their anxiety that a humane plan can be made for their son or daughter when they die.