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Accessible Summaries: Age, Sex, and Constitutional Factors Whittle et al. identify how sex impacts mental health service use for women with intellectual disability.Sheerin et al. highlight how age‐specific needs are unmet due to service gaps.Burke et al. identify how age‐related healthcare risks for bone health are different for people with intellectual disability. Living and Working Conditions van den Bemd et al. reported the recording of management of long‐term conditions for patients with intellectual disabilities in long‐term care appears suboptimal.Skoss et al. report on the infrastructure of group home settings in Australia and how after COVID‐19 people living in these settings receive fewer healthcare services. Individual Lifestyle Factors Lunsky et al. explored the use of a 'check‐in tool' to support people with intellectual disability proactively. Community and Social Networks Donaldson et al. and Karas et al. highlight systemic issues with eyecare and examine the impact of peer‐to‐peer support and community advocacy on improving access to eye care.Schormans et al. examine the lack of social and community support for homeless youth with intellectual disability.Sykes et al. highlight reasonable adjustments and influence of community and familial attitudes in influencing breast and cervical cancer screening access.Earle et al. detail how broader societal and cultural norms affect menstrual health support.Heslop and Lauer found limited evidence about preventing specific avoidable causes of death in people with intellectual disability and outline the need for 'whole population' policy changes.Iffland et al. found that lung infections, choking, flu and heart problems were much more likely to be a contributing cause of deaths for people with intellectual disability.Hatton et al. explore the impact of COVID‐19 on access to health services and highlight severe disruptions during the pandemic which persisted and worsened postpandemic.Beeken et al. detail how stakeholder engagement in research and policymaking can improve health and address health inequalities. [ABSTRACT FROM AUTHOR]

Background: Studies have found that presence of challenging behaviours and mental health problems limits employment for people with intellectual disabilities. This study investigates the associations between age, gender, living condition, level of intellectual disability, diagnoses, behaviour, mental health, and employment in adults with intellectual disabilities in Norway. Method: A cross‐sectional community‐based survey including 214 adult participants (56% men) with intellectual disabilities. Results: In our sample, 25% had no organised day activity, 27% attended non‐work day care, 19% attended sheltered employment, or day care with production, without pay and 29% worked in paid sheltered employment. One participant attended mainstream employment. Moderate and severe/profound level of intellectual disability, possible organic condition and irritability significantly reduced the odds of employment (paid and unpaid). Conclusion: Findings suggest unequal access to the sheltered employment that was meant to be inclusive. More individualised evaluation of prerequisites is suggested to further facilitate employment for this group. [ABSTRACT FROM AUTHOR]

Background: Clinicians recommend including carers or others in a supporting role in the therapy as an important adaptation of psychological therapies for people with intellectual disabilities. This nested qualitative study from a larger trial explored supporters' experiences of supporting people with intellectual disabilities receiving behavioural activation or guided self‐help therapies for depression. Method: Twenty‐one purposively sampled supporters were interviewed. The semi‐structured interviews were subject to framework analysis, covering expectations of therapy, views of therapy sessions, relationships with therapist and participant, and perceived changes. Results: Supporters were positive about both therapies and reported both therapy‐specific and nonspecific therapeutic factors that had significant positive impacts on people's lives. Most supporters reported their involvement contributed to the interventions' effectiveness, and helped establish closer relationships to the people they were supporting. Conclusions: The presence of supporters within psychological therapies for people with intellectual disabilities can be an effective adaptation to therapies for this population. [ABSTRACT FROM AUTHOR]

Background: A recovery approach within mental health services has gained momentum. Its meaning for adults with intellectual disabilities recovering from mental health disorders is less understood. Peoples' experiences of recovery were explored to help inform recovery‐focused recommendations for clinical practise. Method: A qualitative design using interpretative phenomenological analysis was applied. Nine interviews with people with intellectual disabilities who had experienced mental health disorders were conducted. Results: Two themes that emerged focusing on entry to service and the recovery experience. Subthemes for entry to service included unfair treatment, valuing information and managing expectations. The recovery experience subthemes were therapeutic alliance, self‐management, emotional development, autonomy, connectedness, positive identity and a belief in recovery. Conclusions: Hearing peoples' experiences directly allowed the current themes to emerge in the context of living with lifelong disabilities. This article adds to the sparse literature and highlights considerations for recovery‐based interventions for people with intellectual disabilities. [ABSTRACT FROM AUTHOR]

Accessible summary Some people who find it hard to manage their emotions can be helped by a therapy called Dialectic Behaviour Therapy (DBT). Some studies show that DBT might help people with an intellectual disability., We ran a group to see if DBT helped people coming to the group to feel better and manage their difficult feelings more easily. Group members brought their support staff to the group., We asked people what they thought about the group and asked them to fill in some questionnaires to see whether they felt better., The group seemed to help people, even after the group ended., We think DBT might be a useful treatment for people with intellectual disabilities., Abstract Background A growing body of evidence supports the use of Dialectic Behaviour Therapy with people with an intellectual disability. Various adaptation have been used in studies exploring the efficacy of this intervention. Method A Dialectic Behaviour Therapy DBT skills training group was attended by people with an intellectual disability and their support staff. Standardised measures of psychological well-being, overall functioning and psychological distress were taken before and after the group and at 4 months follow-up. Qualitative interviews were conducted and analysed using thematic analysis. Results Results suggested an improvement in all areas for three of the four participants, which were largely maintained at follow-up. Conclusions This study adds to the growing literature supporting the use of DBT with people with an intellectual disability. The role of support workers in supporting generalisation of skills is considered. Ideas for improving the quality of future studies are considered. [ABSTRACT FROM AUTHOR]

Background People with intellectual disabilities (ID) should be able to access the Improving Access to Psychological Therapies ( IAPT) programme, currently a main provider of mainstream mental health services in England. IAPT offer cognitive behavioural therapy ( CBT) to individuals experiencing mental health problems, although its effectiveness for people with ID, when delivered within IAPT, is unclear. Method Ten high-intensity therapists took part in semi-structured interviews, analysed using thematic analysis, regarding their experiences of delivering CBT to people with ID in IAPT. Results The rigidity of the IAPT model appears to offer a poor fit with the needs of people with ID. Therapists appeared uncertain about how to modify CBT and highlighted training and service development needs. Conclusions Findings suggest barriers to accessing IAPT largely remain unaddressed where people with ID are concerned. Services may need to reconsider what constitutes appropriate reasonable adjustments to ensure equitable access. [ABSTRACT FROM AUTHOR]

Background The Improving Access to Psychological Therapies (IAPT) service was established to address common mental health problems among the English population in a timely manner in order to counter the social and economic disadvantage accompanying such difficulties. Using the concept of candidacy, we examined how the legitimacy of claims by people with intellectual disabilities to use this service is facilitated or impeded. Method We used a sequential mixed methods design. We completed 21 interviews with a range of stakeholders, including people with intellectual disabilities and their carers. Themes from the interviews were used to design an online survey questionnaire that was returned by 452 staff from IAPT and specialist intellectual disability services. Results Using the candidacy framework, we noted that eligibility and access to IAPT were achieved through dynamic and iterative processes of negotiation involving people with intellectual disabilities and their supporters on one side and IAPT staff and service structures on the other. Barriers and facilitators were apparent throughout the seven dimensions of candidacy (identification, navigation, permeability of services, appearances, adjudications, offers and resistance and operating conditions) and were linked to discourses relating to the character and purpose of IAPT and specialist intellectual disability services. Conclusions Opportunities exist for some people with intellectual disabilities to assert their candidacy for IAPT input, although there are barriers at individual, professional, organisational and structural levels. More attention needs to be paid to how principles of inclusiveness are operationalised within IAPT teams and to the mental health facilitation role of specialist intellectual disability staff. [ABSTRACT FROM AUTHOR]

Background: There is strong evidence indicating that paid employment is generally good for the physical and mental health of the general population. This systematic review considers the association between employment and the health of people with intellectual disabilities. Methods: Studies published from 1990 to 2018 were identified via electronic literature databases, email requests and cross‐citations. Identified studies were reviewed narratively. Results: Twelve studies were identified. Studies were generally consistent in reporting an association between being in paid employment and better physical or mental health status. Conclusions: This review supports the view that the well‐established association between employment and better health is similar for adults with and without intellectual disabilities. However, evidence establishing causality is lacking and further research to determine specific health benefits attributable to employment for people with intellectual disabilities and the causal pathways that operate is required. [ABSTRACT FROM AUTHOR]

Background: Mothers of people with intellectual disabilities (IDs) face exceptional challenges and may be more prone to experiencing mental ill‐health compared with mothers of typically developing people. These mental ill‐health problems may differ at different stages of the caregiving trajectory. However, there is no evidence synthesis on this topic. We aimed to systematically review evidence in this area and identify gaps in the existing literature. Method: Prospero registration: CRD42018088197. Medline, Embase, CINAHL and PsycINFO databases were searched. No time limits were applied. Studies were limited to English language. Inclusion criteria were studies of mothers of people with IDs that also included a comparison group of mothers of typically developing/developed children. Data were extracted from selected studies using a structured database. Study selection and quality appraisal were double rated. Where possible, meta‐analyses were performed. Results: Of the retrieved articles, 32/3089 were included, of which 10 reported on anxiety, 21 on depression and 23 on other indicators of mental ill‐health. Overall, previous studies reported that mothers of people with IDs experienced poorer mental health as compared with mothers of typically developing people. Meta‐analyses revealed significant findings for anxiety, depression, parenting stress, emotional burden and common mental disorders, but not for somatic symptoms. However, there was a considerable heterogeneity; hence, interpretation of results should be cautious. Identified gaps included scarce research on mental ill‐health of mothers of adults with IDs at different stages of the caregiving trajectory. Conclusions: There is evidence of poorer mental ill‐health in mothers of people with IDs compared with mothers of typically developing people, but lack of focus on different stages of the caregiving trajectory, methodological inconsistencies between studies and lack of robust studies pose limitations. This highlights the need both for improved support for mothers of people with IDs and for further methodologically robust research. [ABSTRACT FROM AUTHOR]

Background The Mental Health Service for People with Learning Disabilities (MHSPLD) is a service development in keeping with UK government policy that promotes cross agency working and access to mainstream mental health services for people with intellectual disabilities. We aimed to show whether the service model brought about improvements in people’s mental state and level of functioning. Method Community and inpatient groups were compared across three time points using a range of clinical outcome measures that assessed psychiatric symptoms, risk, needs and level of functioning. Results Inpatients and community groups had similar mental health problems, but inpatients had higher unmet needs and lower functioning, and were at greater risk. There were significant improvements across the range of outcome measures in both groups. Conclusions Working with mainstream mental health services and across health and social service boundaries delivers effective mental health care for people with intellectual disabilities. [ABSTRACT FROM AUTHOR]

Background There is growing evidence that people with intellectual disabilities have greater healthcare needs than the general population and that these needs are often unmet. Recently, increasing attention has been drawn to poor care received by people with intellectual disabilities when admitted to hospital. Method A literature search was conducted to identify studies on experiences of secondary healthcare for people with intellectual disabilities. Studies were published between January 1990 and March 2008. Results Thirteen studies were identified. Important influences on the experience of hospital care were: individual factors; the carer’s role; the attitudes, knowledge and communicative style of health staff; and the physical environment. A range of recommendations and initiatives have been developed to improve hospital care. Conclusion More research is needed, given that so few studies are published in this area. Initiatives to improve access to secondary healthcare need to be evaluated to inform the development of services. [ABSTRACT FROM AUTHOR]

Background Models of service provision and professional training differ between countries. This study aims to investigate a specialist intellectual disabilities model and a generic mental health model, specifically comparing psychiatrists’ knowledge and competencies, and service quality and accessibility in meeting the mental health needs of people with intellectual disabilities. Method Data were collected from consultant and trainee psychiatrists within a specialist intellectual disabilities model (UK) and a generic mental health model (Australia). Results The sample sizes were 294 (UK) and 205 (Australia). Statistically significant differences were found, with UK participants having positive views about the specialist intellectual disabilities service model they worked within, demonstrating flexible and accessible working practices and service provision, responsive to the range of mental health needs of the population with intellectual disabilities, and providing a wide range of treatments and supports. The UK participants were knowledgeable, well trained and confident in their work. They wanted to work with people with intellectual disabilities. In all of these areas, the converse was found from the Australian generic mental health service model. Conclusions The specialist intellectual disabilities model of service provision and training has advantages over the generic mental health model. [ABSTRACT FROM AUTHOR]

Health status is an important domain of quality of life of people with intellectual disabilities. This paper describes the development of a self-report health status measure for use with people with intellectual disabilities living in staffed community-based accommodation, and reports preliminary reliability data for the schedule.Question and response items were adapted from a well-established measure (SF-36) used in the general population incorporating subscales such as General Health, Physical Functioning, Bodily Pain, Vitality, Mental Health, and Sensory Functioning. A variety of closed and open response formats were used based on the growing literature examining methods for interviewing people with intellectual disabilities.Internal reliability and response consistency were investigated. Reliability for Physical Functioning, General Health and Bodily Pain was reasonable, but was unsatisfactory for Sensory Functioning, and Mental Health.The findings are discussed in light of the challenge of eliciting reliable responses from people with intellectual disabilities. Question methodologies can be built upon in further research. [ABSTRACT FROM AUTHOR]

Mental health problems are known to be hard to recognize in people with intellectual disabilities. One factor that may contribute to this is the diagnostic overshadowing bias, which describes the tendency of the clinicians to overlook symptoms of mental health problems in this client group and attribute them to being part of ‘having an intellectual disability’. Although a small amount of research has investigated this in the USA, very little has taken place in the UK. Two clinical vignettes were produced. Both described identical clinical problems, except that one vignette described a man with an IQ of 58 and impaired social functioning (i.e. an intellectual disability) and one a man with an IQ of 108 and normal social functioning (i.e. non-intellectually impaired). Psychiatrists ( n = 274) and clinical psychologists ( n = 412) throughout UK were randomly assigned to either the low IQ or normal IQ condition, and sent a corresponding clinical vignette. One hundred and thirty-three psychologists and 90 psychiatrists responded. Diagnostic overshadowing did appear to be present. Clinicians were more likely to recognize a range of symptoms in those with IQs in the normal range than those with intellectual disabilities. Furthermore, psychiatrists appeared more likely to make this error under some circumstances than clinical psychologists. Diagnostic overshadowing may contribute to the difficulties that mental health professionals commonly experience in identifying mental health problems in people with intellectual disabilities. However, the methodology commonly used in this type of research has a number of weaknesses, and would benefit from an alternative approach. [ABSTRACT FROM AUTHOR]

Background The use of physical intervention (PI) with people with intellectual disabilities continues to cause concern. This study sought to clarify the frequency and circumstances of PI use and gather data on the characteristics of individuals subject to PI. Method Data on individuals subject to PI were gathered by postal questionnaire completed by service providers from three samples: people who (i) had attended a PI conference and/or purchased a PI policy document; (ii) operated in a specific geographical area of England and (iii) operated specialist assessment and treatment settings for children/adults with intellectual disabilities throughout the UK. Results Frequent PI use was reported. Restraint was most commonly reported – monthly or more frequently with most individuals. Overall, those receiving PI were more likely to be young, male, not legally restricted and identified as having an autistic spectrum disorder than those who did not receive PI. Conclusions The relatively frequent use of PI is consistent with routine rather than last resort use. Such use carries risk of physical and psychological damage. Service providers should systematically reduce the frequency of use of PI. [ABSTRACT FROM AUTHOR]

Background Within the context of current legislation relating to mental capacity in adults, the capacity of people with intellectual disabilities to consent to take part in research studies and the impact of different forms of information provision was experimentally investigated. Materials and methods A questionnaire measure of ability to consent to take part in this research study was administered individually to participants. A total of 102 participants with intellectual disabilities were recruited from three day services for adults with intellectual disabilities. Consent information appertaining to taking part in an actual research project was presented to participants and their capacity assessed using a questionnaire. Three experimental conditions were used: • Control ( n = 34) – consent information was presented followed by the questionnaire. • Section ( n = 34) – consent information was broken into sections and the appropriate questions were asked following each section. • Photograph ( n = 34) – consent information was accompanied by six colour photographs, followed by the questionnaire. Participants also completed measures of memory ability, verbal ability and non-verbal problem-solving ability. Results Seventeen participants withdrew from the study at some point. Of the remaining 85 participants, no significant differences in ability to consent scores were found between the experimental conditions. Using this measure, only five participants (5.9%) were deemed able to consent, i.e. scored the minimum required on each aspect of consent. Conclusions The validity and usefulness of the current dichotomous concept of consent is challenged as only a small proportion of participants were deemed able to consent. [ABSTRACT FROM AUTHOR]

Background Previous studies have suggested different patterns of associations between psychiatric symptoms and problem behaviours in people with intellectual disabilities (ID). The aim of this study was to investigate which problem behaviours are associated with specific psychiatric symptoms and the relative strength of these specific associations. Method A cross sectional survey using the Psychiatric Assessment Schedule for Adults with Developmental Disabilities Checklist and the Disability Assessment Schedule was carried out in a sample of 214 adults with ID. Results Self-injurious and, to a lesser extent, aggressive problem behaviours were most associated with affective type symptoms. Screaming and destructive behaviours tended to be more associated with autism-related social impairment rather than conventional psychiatric symptoms. Conclusions This study gives further evidence of associations between psychiatric symptoms and specific problem behaviours in people with ID. It may be particularly useful to consider the diagnosis of affective disorders if a person with ID shows self-injurious or aggressive behaviours. [ABSTRACT FROM AUTHOR]

Background: We aimed to validate the Italian version of the two parallel short forms of the Prudhoe Cognitive Function Test (s‐PCFT‐I) in adults and seniors with intellectual disabilities (ID) of any aetiology and level of severity. Methods: Our validation is a multicentre study attended by 211 subjects with ID, 125 male and 86 female, aged 40 years and above for people with Down syndrome and aged 50 years for people with other forms of disabilities. Results: The s‐PCFT‐I shows a wide range of scores in the absence of floor effects with minimal ceiling effects. A Cronbach's α coefficient of 0.85 and a mean inter‐item correlation of 0.21 indicate high internal consistency. The tool demonstrates good agreement between testers and near excellent temporal stability with intraclass correlation coefficients respectively of 0.85 and 0.90. s‐PCFT‐I total scores do not differ by sex or age, while statistically significant differences are observed between people with different levels of severity of ID. Moderate to good and highly significant correlations (−0.40 to −0.66) among the s‐PCFT‐I total scores and subscores and the Sum of Cognitive Score of the informant‐based Dementia Questionnaire for Persons with Intellectual Disabilities suggest an acceptable level of concurrent criterion validity. Cognitive decliners according to Prasher's Dementia Questionnaire for Persons with Intellectual Disabilities cut‐off scores perform significantly lower on s‐PCFT‐I than non‐decliners. Conclusions: The s‐PCFT‐I has good psychometric properties and user friendliness and may therefore be a valuable addition to the current informant‐rated tools for screening and assessment of cognition in aging people with ID. [ABSTRACT FROM AUTHOR]

Introduction: The measures implemented to manage the COVID‐19 pandemic have been shown to impair mental health. This problem is likely to be exacerbated for carers. Method: Informal carers (mainly parents) of children and adults with intellectual disabilities, and a comparison group of parents of children without disabilities, completed an online questionnaire. Almost all the data were collected while strict lockdown conditions were in place. Results: Relative to carers of children without intellectual disability, carers of both children and adults with intellectual disability had significantly greater levels of a wish fulfilment coping style, defeat/entrapment, anxiety, and depression. Differences were 2–3 times greater than reported in earlier pre‐pandemic studies. Positive correlations were found between objective stress scores and all mental health outcomes. Despite their greater mental health needs, carers of those with intellectual disability received less social support from a variety of sources. Conclusions: The greater mental health needs of carers in the context of lesser social support raises serious concerns. We consider the policy implications of these findings. [ABSTRACT FROM AUTHOR]

Background Although there is an established body of evidence attesting to the dose–effect relationship in psychotherapy with non-disabled adults, the issue as to whether such a relationship exists for persons with intellectual disabilities has not been previously examined. Dose–effect essentially concerns the amount of psychotherapy required to produce positive results. Method The current study used a naturalistic design to examine and compare the outcomes of three groups of participants with co-morbid psychological problems undergoing treatments of differing lengths (i.e. ‘doses’) with psychodynamic psychotherapy. Three measures of psychopathology were completed at assessment and at subsequent eight-session intervals until the conclusion of treatment. Each patient received a 3-month follow-up appointment, at which time the measures were again completed. Three treatment duration groups were subsequently constructed and compared viaanova: eight sessions ( n = 8), 16 sessions ( n = 5) and 24 plus sessions ( n = 7). Results Results were supportive of a dose–effect relationship, in that outcomes were generally equivalent regardless of treatment duration. Conclusion In short, most change appears to occur in the first eight sessions of treatment, with subsequent outcomes trailing off over time. The clinical implications of the study are discussed in the context of the methodological limitations identified. [ABSTRACT FROM AUTHOR]

The aims were to: (i) explore the association between age and size of setting and staffing per resident; and (ii) report resident and setting characteristics, and indicators of service process and resident activity for a national random sample of staffed housing provision. Sixty settings were selected randomly from those accommodating six or fewer adults with intellectual disabilities in Wales. Nine settings subsequently withdrew. Information from the remaining 51 was obtained on resident ages, gender, adaptive behaviour, physical and sensory disabilities, social impairment and challenging behaviour, the number and working hours of staff, staff:resident ratios at different times of the day, working practices, resident receipt of attention and assistance from staff and resident activity. The sample of 51 residences was divided into four groups of 12, 13, 13 and 13 settings each, according to ascending average adaptive behaviour scale scores. Age of residence was associated with larger size of residence and fewer staff hours per resident. Higher staffing per resident was associated with smaller setting size. Staffing per resident differed across adaptive behaviour groups to a limited extent. Size and age of residence, working practices, resident receipt of attention and assistance from staff did not differ across groups but resident engagement in activity did. Considerable within-group variation was found. The data illustrate trends in provision over time. In addition, they give a picture of recent practice and raise questions about whether staff input, on one hand, and staff training and performance, on the other hand, are well enough matched to the different needs of residents at different points of the adaptive behaviour spectrum. [ABSTRACT FROM AUTHOR]

Accessible summary: Dialectical Behaviour Therapy (DBT) is a therapy to help people manage their feelings.We ran a DBT group for people with an intellectual disability. The group seemed to help people feel better and manage their feelings, even after the group ended.The group was 2 years ago. We talked to three people who went to the group to see what people still remembered from the group and if DBT was still helping them.We think having a top‐up session might help people to remember and practise ideas from the group. Background: This paper reports quantitative and qualitative follow‐up data from three participants who attended a Dialectical Behaviour Therapy (DBT) group for people with an intellectual disability. Materials and Methods: Quantitative data regarding psychological well‐being, psychological distress (measured using the Psychological Therapies Outcome Scales; PTOS) and quality of life (measured using the Health of the Nation Outcome Scales—Learning Disability; HONOS‐LD) are reported for pre‐group, post‐group and at 6‐month and 2‐year follow‐up. Interviews were conducted with participants post‐group and at 2‐year follow‐up. Data were analysed using thematic analysis. Results: Improvements in scores on measures of psychological well‐being, psychological distress and quality of life appear to be maintained at 6‐month follow‐up, but scores at 2‐year follow‐up suggest a return to baseline. Qualitative self‐report data suggest a number of interesting ways participants adapted and individualised techniques from the group, as well as suggesting possible barriers to maintaining change in the longer term. Conclusions: Clinical implications are considered to improve effectiveness of similar interventions, as well research implications in order to improve knowledge about the longer term impact of group DBT interventions. [ABSTRACT FROM AUTHOR]

Accessible summary: Family members often support people with intellectual disabilities who display challenging behaviour. Family carers should be listened to and included in important decisions. We asked family carers how professional services had helped their relative with challenging behaviour. Family carers said that the care of people with intellectual disabilities who display challenging behaviour can be improved. Family carers sometimes felt left out of decisions and said that they needed more information. Listening to parent carers' experiences can help to improve the services that are provided to people with intellectual disabilities and their families. Abstract: Background: There is relatively little published data that report the experiences and views of family carers of people with intellectual disabilities who display challenging behaviour who are prescribed psychotropic medication. Materials and methods: An online structured questionnaire was created by the Challenging Behaviour Foundation, a UK charity, and family carers of people with intellectual disability. Questions concerned the management of challenging behaviour and asked family carers about their experiences and views on the use of psychotropic medication. Responses were gathered between August and October 2016. Results are summarised using descriptive and inferential statistics and descriptive analysis of free‐text comments. Findings: Ninety‐nine family carers completed the survey. Family carers reported gaps in the holistic and proactive management of challenging behaviour. Whilst some felt involved in decisions around psychotropic medication prescribing, others described feeling marginalised and lacking information and influence. The decision to prescribe psychotropic medication evoked complex emotions in family carers and medication use was associated with mixed outcomes in those prescribed. Family carers identified areas of good practice and those areas where they believe improvements are needed. Conclusions: Psychotropic medication should be only one option in a multimodal approach to challenging behaviour, but this may not always be reflected in current practice. Greater effort needs to be made to ensure that services are equipped to provide optimum care and to embed shared decision‐making into routine practice. [ABSTRACT FROM AUTHOR]

Background: No studies have explored the acceptability of Behavioural Activation and Guided Self‐Help interventions for depression with people who have intellectual disabilities. Method: Twenty‐five participants were purposively sampled from participants taking part in a trial comparing Behavioural Activation with a Guided Self‐Help intervention. A framework analysis was used to analyse interviews covering participants' expectations and views of therapy. Results: Participants were largely positive about both interventions. However, they identified specific aspects of each intervention which they had found helpful. All participants valued the therapeutic relationship. The participants also had a number of criticisms and suggestions for improving the therapies. A common concern was the time‐limited nature of the interventions and a wish for longer‐term help. Overall, both sets of participants felt the interventions had relevance for their wider lives. Conclusions: The participants reported having positive engagement with the therapies but expressed a wish for longer‐term supportive relationships. [ABSTRACT FROM AUTHOR]

Accessible summary People with Down syndrome and intellectual disabilities are more likely to get dementia when they are older. This is an illness where people become forgetful and confused. Sometimes people with Down syndrome start to behave strangely at the start of the illness. They have difficulties solving problems or have changes in their behaviour. This is called executive functioning., We looked at some different tests to see whether they could help us understand whether someone was having problems with their executive functioning skills., We found that the tests can be useful and that we should be using them with more people. We think that we need to wait for a longer time before finding out whether they can tell us whether someone has dementia or not., This is important for people with intellectual disabilities as we need to find the right tests to help us diagnose dementia as early as possible., Summary The following article details a piece of service development work undertaken as part of the Plymouth Down Syndrome Screening Programme. The work aimed to review the use of three measures assessing executive functioning skills used within the Programme as well as with people without Down syndrome. Three tasks assessing executive functioning (the Weigl, Cats and Dogs, and verbal fluency task) were evaluated. The Weigl task was removed from the Programme and analyses due to floor effects and difficulties in administration. Correlation analyses showed relationships between the Cats and Dogs task and two other measures, cognitive skills as reported by carers and object memory. No relationships were found between the verbal fluency task and other measures. A full consideration is given to these findings, and implications for future practice are considered. Further data are needed to make full conclusions about the value of the tasks in predicting dementia in people with intellectual disabilities and people with Down syndrome. Further recommendations concerning the development of the assessment of executive skills are also considered. [ABSTRACT FROM AUTHOR]

Background The Psychiatric Assessment Schedule for Adult with Developmental Disability (PAS-ADD) is an international reference tool for the diagnosis and assessment of mental health problems and behavioural disorders among people with intellectual disabilities. Although the original PAS-ADD instrument has been validated in the Spanish language, the shorter PAS-ADD Checklist has yet not been validated. The aim of this study is to validate the PAS-ADD Checklist for the Spanish population. Methods The PAS-ADD Checklist Questionnaire was administered to 208 adults with intellectual disabilities at a vocational centre in Madrid, Spain. The psychometric analyses included internal consistency, inter-rater and test-retest reliability, Varimax rotation factor analysis for construct validity, criterion validity and feasibility. Results The Cronbach's alpha was 0.80 for the overall questionnaire and between 0.40 and 0.79 for the subscales. The Kappa coefficients for test-retest and inter-rater reliability were between 0.66 and 0.80. Varimax rotation factor analysis showed five well-defined factors. The Kappa coefficients for criterion validity were between 0.30 and 0.70. Feasibility was also good. Conclusions The PAS-ADD Checklist is a feasible and reliable instrument for carrying out initial assessment of the mental health status of adults with intellectual disabilities, referring cases to more specialised diagnosis and treatment. [ABSTRACT FROM AUTHOR]

Background Government guidelines promote the use of mainstream mental health services for people with intellectual disabilities whenever possible. However, little is known about the experiences of people with intellectual disabilities who use such services. Materials and Methods Face-to-face interviews with service users, carers and community nurses were completed and analysed on a case by case basis using interpretative phenomenological analysis. The results were followed up in focus groups with service providers. Results Positive aspects included the provision of respite, particularly for carers, and good basic care. These were outweighed by a perception of the admission as disempowering and lacking in flexible treatment provision. Accessing help emerged as a major problem, as well as the prospect of staff neglecting the specific needs of people with intellectual disabilities. Conclusions While there were some indications of improvements in line with recent policies and guidance, mainstream services seem a long way off realizing aims of easy accessibility, person-centred practices and active partnership with intellectual disability services. [ABSTRACT FROM AUTHOR]

Background Research into self-harm among people with intellectual disabilities has focused predominantly on high frequency internally maladaptive behaviour among people whose disability is severe or profound. Research into different forms of self-harm, such as cutting or burning the skin, found in those with mild intellectual disabilities; especially those living in secure accommodation, has largely been neglected, although there has been recognition of its impact on individuals and staff working in this field. This study aimed to address this issue through exploration of the experiences and understanding of self-harm among people with intellectual disabilities living in secure accommodation. A second aim was to explore experiences of interventions associated with this behaviour. Method and Results Semi-structured interviews were carried out with nine people who self harm, have intellectual disabilities and had been placed in secure accommodation. Interpretative Phenomenological Analysis yielded three master themes. The first related to the interpersonal context of self-harm and included sub themes relating to past experiences of abuse and loss, and current issues of control and protection. The second master theme related to the emotional experience of self-harm, which varied throughout the process of self-harm and was characterized by anger, frustration, hopelessness, relief, guilt and regret. The third master theme related to the management of self-harm. Participants had experience of helpful individual and collaborative strategies, as well as interventions that were experienced as controlling, unhelpful or ridiculing. Conclusion Emerging themes are considered in relation to the wider-self-harm literature and current psychotherapeutic models. A number of limitations to the study are noted and the use of this methodology with people with intellectual disabilities was discussed. [ABSTRACT FROM AUTHOR]

Background/Introduction: In this study, we investigated intellectual disability support professionals' knowledge and expectations towards effects of psychotropic drug use on behaviour and drug use in their clients, because shortcomings may lead to misinterpretations of behavioural symptoms and inappropriate drug use. Methods: Two self-designed questionnaires were used to measure the knowledge and expectations of 194 support professionals in 14 residential facilities regarding psychotropic drug use and effects of antipsychotics on behavioural, cognitive and mental functioning of people with intellectual disability. The psychometric properties of both questionnaires were adequate. Results: A majority of the professionals had unrealistic expectations regarding the positive effects of antipsychotics on cognitive and behavioural functioning, and 94% scored below the cut-off scores regarding knowledge; 60% indicated they needed education and training. Conclusions: To achieve sufficient collaboration of intellectual disability support professionals in reducing inappropriate psychotropic drug use of clients, vocational educational training is needed. [ABSTRACT FROM AUTHOR]

Abstract: Background: Individuals with intellectual disability (ID) are at greater risk of exposure to traumatic life events compared with the non‐ID population. Yet no study to date has examined the role of multiple traumatisation and subsequent psychopathology in people with ID. The aim of this study was to explore the association between multiple traumatisation and subsequent mental health. Methods: A preliminary cross‐sectional study involving 33 participants with DSM‐5 post‐traumatic stress disorder completed self‐report questionnaires on exposure to traumatic life events and post‐traumatic stress disorder symptoms, anxiety, depression and general distress. Results: A proportion of 42.4% of the sample reported multiple traumatisation, including exposure to life events in both childhood and adulthood. Those who reported exposure to life events in childhood and adulthood reported significantly higher risk of harm, depression and general psychological distress compared with those who reported exposure to life events only in adulthood. Conclusions: Preliminary results indicate that more severe psychopathology is associated with multiple traumatisation in childhood and adulthood compared with trauma experienced solely in adulthood. [ABSTRACT FROM AUTHOR]

Accessible summary: Mindfulness helps us to "slow down" and notice how we are thinking and how we are feeling. When we notice our thoughts and our feelings, we can choose to do the things that help us to feel better. We wanted to know what people with learning disabilities thought of mindfulness. Nine people with learning disabilities told us what they thought about mindfulness. We found out that: People enjoyed mindfulness activities and the chance to socialise with other peoplePeople showed some understanding of mindfulnessPeople could do the mindfulness activities Background: A growing body of research supports the efficacy of mindfulness‐based intervention programmes (MBPs) for people with intellectual disabilities. Existing literature calls for focus on the experiences of people with intellectual disabilities participating in MBPs. Materials and Methods: This study explored the experiences of nine adults with intellectual disabilities attending an eight‐week group MBP delivered within the community. Two audio‐recorded group discussions and seven semi‐structured interviews were thematically analysed. Results: Themes were as follows: participants' experience of the group as a meaningful and enjoyable activity; opportunities for socialisation, sharing, friendship and support; the significance of participant–facilitator relationships; and how participants understood and experienced the mindfulness exercises and concepts. Conclusions: Some understanding of mindfulness was evident, and participants demonstrated an ability to engage in mindfulness exercises. Findings inform the development of effective MBPs for people with intellectual disabilities. [ABSTRACT FROM AUTHOR]

Background: To address the growing concerns over poor mental health experienced by adults with intellectual disabilities due to the COVID‐19 pandemic, a national virtual mental health course was delivered and evaluated. Methods: This mixed methods study utilized both qualitative and quantitative assessments. Participants were 27 adults with intellectual disabilities who participated in the 6‐week course. Participants completed measures of self‐efficacy and well‐being at three time points and qualitative satisfaction measures at post and follow‐up. Results: Attendance was high and the course was feasible and acceptable to participants. Positive changes related to mental health self‐efficacy were detected (p =.01), though mental well‐being did not improve. Conclusion: The study provided evidence for the feasibility and value of the course for this population. Future research should examine how virtual courses could support the population in terms of pandemic recovery and how courses may work for individuals who are less independent. [ABSTRACT FROM AUTHOR]

Various conceptional dimensions of aging are relevant for epidemiological research on health issues for individuals with intellectual disabilities (ID). In a review of the literature results of mortality and morbidity studies are documented and discussed regarding the actual health status of elderly adults with ID. Most of these studies are based on indirect assessments with several sources for detection bias. As a consequence, health problems are systematically undocumented and underreported for this target group and affect the effectiveness and adequacy of health service delivery. Direct assessment procedures and methods in epidemiological research are suggested as one means to improve research used to support health care planning. Such a methodological target can be combined with the more important goal on service level of finding and helping persons with unrecognized treatable conditions. [ABSTRACT FROM AUTHOR]

Background: Family members caring for children with intellectual disability (ID) routinely report heightened levels of psychological distress. However, families of children with Down syndrome typically report better outcomes (known as the Down syndrome advantage). We examined whether the Down syndrome advantage would be present for maternal psychological distress, impact of caregiving, life satisfaction and perceived positive impact of the child with ID when controlling for external variables. Methods: Mothers of children with Down syndrome (n = 111) and mothers of children with ID of mixed aetiologies (n = 196) completed measures about their own mental health, perceived impact of caregiving, life satisfaction and perceived positive impact of their child on themselves and the family unit. Results: A series of group comparisons revealed small to moderate differences supporting the presence of a putative Down syndrome advantage in relation to personal maternal well‐being outcomes. However, when child‐related characteristics and external variables were controlled, the Down syndrome advantage was no longer present, with reduced, small effect sizes observed for all maternal outcomes. Conclusions: Initial group differences in psychological distress and life satisfaction were largely associated with family poverty, indicating that the Down syndrome advantage may be less robust than previously thought. Future research should seek to move beyond examining the existence of the putative Down syndrome advantage and focus on how families of children with Down syndrome experience family life, including longitudinal research exploring responses to life cycle and transition challenges. [ABSTRACT FROM AUTHOR]

Background: During the COVID‐19 pandemic, social distancing measures were enforced and the national lockdown underlined our reliance on virtual means as a way to communicate. This new way of interacting highlighted that people with an intellectual disability were a large proportion of a digitally excluded population. Methods: A service evaluation, using a mixed method design in the form of four self‐reported outcome measures and qualitative feedback. Findings: Clinical services need to continue when face to face sessions are not possible. Remote groups can be an alternative option not only when self‐isolating due to pandemics but when living in remote locations, having physical health problems or excessive expenses and travel costs. Conclusions: Online dramatherapy groups can be a beneficial alternative when face to face groups are not possible or challenging to attend due to access difficulties. Online groups can offer opportunities to meet with peers, build relationships, improve confidence and learn new skills in technology. Accessible summary: Groups delivered online, using the internet, are an option for people with an intellectual disability when attending a group in the community is not possible.Online dramatherapy groups can provide people an opportunity to share stories and experiences through creative means.Friendships can be established through facilitated online group platforms.Online groups introduce people to technology and opportunities to learn digital skills that can be used outside the group. [ABSTRACT FROM AUTHOR]

Background: The Improving Access to Psychological Therapies (IAPT) programme has been impactful in increasing access to psychological therapies at primary care level. However, it remains unclear whether IAPT's widely disseminated achievements include the reduction in service users' transition to secondary care services and whether IAPT services are providing interventions that match the level of complexity of presenting problems of those who are referred., Aims: This review sets out to clarify the clinical characteristics of IAPT cohorts, whether the interventions provided target these characteristics, and whether outcomes are related to the use of the stepped-care model advocated in the operationalization of IAPT services., Method: A systematic literature search was undertaken on PsycINFO, MEDLINE, and Embase using the terms: IAPT, anxiety, and depression., Results: Of 472 paper identified, 24 articles were deemed pertinent. It appears that IAPT cohorts are complex and current service delivery frameworks may not meet their needs. IAPT developments and research for long-term physical health conditions and serious mental illness have been recently advocated, though whether these are sufficient and viable when set in IAPT's prescriptive backdrop remains unclear., Conclusions: Improving Access to Psychological Therapies provision and research at present does not adequately consider the complexity of its clientele in the context of treatment outcomes and service delivery. Recommendations are provided for future research and practice to tackle these deficiencies., Practitioner Points: Improving Access to Psychological Therapies (IAPT) has significantly increased access to psychological therapies within primary care over the last decade, though it is unclear whether its interventions are sufficiently tailored to meet the actual levels of complexity of its clientele and prevent them from needing onward referral to secondary care as originally envisaged. Given the ongoing focus on and investment in IAPT informed developments into long-term conditions and serious mental illness, this review considers whether additional elucidation of the model's original objectives is required, as a precursor to its expansion into other clinical areas. The review indicates that there is a stark lack of data pertaining to the generalisable, real-world clinical benefits of the IAPT programme as it currently stands. Recommendations are provided for future areas of research, and practice enhancements to ensure the value of IAPT services to clients in the wider context of NHS mental health services, including the interface with secondary care, are considered., (© 2021 British Psychological Society.)

People with intellectual and developmental disabilities (IDD) have significantly poorer health than the general population. A key threat to health programs for people with IDD is commitment from stakeholders, especially service organizations. The aim of this study was to explore the role disability service organizations play in promoting the best possible physical and mental health of people with IDD. To do so, this study analyzed secondary Personal Outcome Measures® data from 1,341 people with IDD in the United States using binary logistic regressions. Our findings revealed that organizational supports can play a key role in promoting the health of people with IDD. By paying attention to all of these aspects of health and supports, especially discrepancies in supports, service organizations can work to counteract health disparities in those they support. [ABSTRACT FROM AUTHOR]

Background: Peer‐delivered interventions are a best practice in mental health, yet no such intervention exists for young adults (YA) with intellectual/developmental disabilities with co‐occurring mental health conditions. We evaluated YA with intellectual/developmental disabilities' ability to deliver a novel peer mentoring intervention with fidelity and the supports received. Methods: We coded audio‐recorded mentoring sessions to evaluate if 4 mentors adhered to 'content' (e.g., psychoeducation) and 'quality' (e.g., validation) fidelity criteria (codes: yes/no). We conducted content analysis of mentor support logs and interviews with mentors', mentors' parents and teachers to describe the supports mentors received. Results: Average fidelity for content criteria (M = 73.3%) was higher than quality criteria (M = 60.0%). Weekly support addressed logistics, delivering content, interpersonal interactions, emotional support, professionalism, and organisation. Family members and teachers rarely provided additional support. Conclusions: With support, YA can deliver a peer mentoring intervention addressing mental health. Additional training activities will be developed to improve fidelity. [ABSTRACT FROM AUTHOR]

Background Transition to adulthood may be a period of vulnerability for health for individuals with intellectual disabilities. No large-scale studies have compared the health of individuals with and without intellectual disabilities undergoing transition. The aims of this study were (1) to compare health during transition for individuals with and without intellectual disabilities across a whole country population and (2) to establish whether transition is associated with health in the population with intellectual disabilities. Methods Data were drawn from Scotland's Census, 2011. Frequency data were calculated for young people with and without intellectual disabilities. Logistic regressions were used to determine the extent to which intellectual disabilities account for seven health outcomes (general health, mental health, physical disabilities, hearing impairment, visual impairment, long-term illness and day-to-day activity limitations), adjusted for age and gender. Within the intellectual disabilities population, logistic regressions were then used to determine whether age group (13-18 or 19-24 years) is associated with the seven health outcomes, adjusted by gender. Results A total of 5556/815 889 young people aged 13-24 years had intellectual disabilities. Those with intellectual disabilities were 9.6-125.0 times more likely to have poor health on the seven outcomes. Within the population with intellectual disabilities, the 19- to 24-year-olds with intellectual disabilities were more likely to have mental health problems than the 13- to 18-year-olds, but did not have poorer health on the other outcomes. The difference between age groups for mental health problems was greater for young people who did not have intellectual disabilities, but their overall level of mental health problems was substantially lower than for the young people with intellectual disabilities. Conclusions This largest-to-date study quantifies the extent of the substantial health disparities experienced by young people with intellectual disabilities compared with people without intellectual disabilities. The young population with intellectual disabilities have substantial health problems; therefore, transition between child and adult services must be carefully planned in order to ensure that existing health conditions are managed and emerging problems minimised. [ABSTRACT FROM AUTHOR]

One in seven children with an impairing mental health disorder has intellectual disability (ID). Despite the ubiquity of ID, many clinicians are less confident in the assessment and management of mental disorders in youth with ID. Key to determining how to modify these is a good understanding of the child's developmental/cognitive strengths and weaknesses. There is very limited evidence for mental health interventions specific to children with ID. In this context, NICE guidelines generally recommend the same interventions identified for typically developing children. However, psychological interventions should be adapted for developmental level and communication ability. Medication should be selected carefully taking account of co‐existing conditions, drug interactions and the greater sensitivity to adverse effects in this population. Assessment and intervention should always take account of the child's wider context, including education. There is little evidence regarding the best service models in relation to efficacy and efficiency, but the high prevalence of ID amongst youth with mental health problems suggests that all mental health professionals should have competence in working with youth with milder levels of ID. [ABSTRACT FROM AUTHOR]

Background: The online mindset intervention The Growth Factory (TGF) has shown promising effects—increasing growth mindsets and perseverance and decreasing mental health problems among youth with intellectual disabilities (ID). Studying moderators and mediators of intervention effects is essential to elucidate for whom and why TGF works. Using a randomised controlled trial design, we examined youth's baseline mindset, gender, age, level of ID and intervention satisfaction as moderators of TGF effects and examined whether the intervention effects of TGF on improvements in mental health were mediated by perseverance. Methods: The sample consisted of 119 participants with mild to borderline ID (Mage = 15.83; SD = 2.23), randomly assigned to the intervention (n = 60) or passive control group (n = 59). Participants reported mindsets, perseverance, internalising, externalising, attention and total mental health problems at pre‐test, at post‐test and at 3‐month follow‐up. Additionally, youth in the intervention group graded their satisfaction with a score at the end of each session. Results: Findings indicated that the effectiveness of TGF was not affected by participants' baseline mindsets, age and ID level. TGF was more effective in reducing internalising problems in girls and increasing perseverance in boys. In addition, in the intervention group TGF was more effective in improving internalising, externalising and total mental health problems for youth who reported higher levels of intervention satisfaction at post‐test. Finally, TGF indirectly decreased internalising and externalising problems at follow‐up through improvements in perseverance reported at post‐test. Conclusions: TGF offers a universal, 'add‐on' mindset intervention complementing usual care programmes. It improves mindsets, perseverance and mental health in youth with ID. Both practical and theoretical implications are discussed. [ABSTRACT FROM AUTHOR]

Background: Psychotropic medication is frequently administered to people with intellectual disability with mental health and/or behavioural problems, instead of other non‐pharmacological interventions. This study describes the mental health and behavioural problems of people aging with intellectual disability, their psychotropic medication intake, and the factors contributing to a greater medication intake. Method: The sample consisted of 991 people with intellectual disability over 45 years. Descriptive statistics and multinominal logistic regression were carried out. Results: Antipsychotics were the most used psychotropic drug. Older people with mild intellectual disability living in institutions and affected by mental health and behavioural problems were more likely to take larger amounts of psychotropic medication. Conclusions: Antipsychotics continue to be widely used by people with intellectual disability and mental and behavioural health problems, especially those in institutionalised settings. Future research should consider if medication intake could be reduced providing better supports in the community and non‐pharmacological interventions. [ABSTRACT FROM AUTHOR]

Accessible Summary: Many young adults with intellectual and developmental disabilities also have mental health challenges, such as anxiety, depression or post‐traumatic stress disorder.Peer mentoring is when people with disabilities support another person with a disability.We worked together to make a peer mentoring programme to help young adults with intellectual and developmental disabilities have better mental health.People enjoyed peer mentoring—they thought it was fun and that their mentors were nice. A few people thought that mentoring would be better if there was more time to do activities with their mentor. Some people felt like mentoring helped them learn ways to cope with their mental health challenges.This article describes the peer mentoring programme, what people liked, what they did not like and how we want to change peer mentoring in the future. This is important, because other people might want to try peer mentoring so people with disabilities can learn from each other. Background: We conducted feasibility testing of a novel peer mentoring intervention addressing self‐awareness and proactive coping for young adults with intellectual and developmental disabilities and co‐occurring mental health conditions. Aligned with regulatory flexibility theory, we hypothesised that if young adults with intellectual and developmental disabilities and co‐occurring mental health conditions learned a range of coping strategies, then they would have greater self‐efficacy for managing their emotions and, subsequently, decreased mental health symptoms. Methods: Five participants (Mage: 20, range: 16–22) were mentored by another young adult with intellectual and developmental disabilities and co‐occurring mental health conditions for 10 sessions. Feasibility data collected included the following: enrollment data, attendance rates, participant and parent member experiences and observation of change (via post‐intervention interviews), and mentoring satisfaction via a mentoring questionnaire (range 15–60). Findings: Our enrolment rate was 16%. Mentoring was acceptable to young adults, as demonstrated by high attendance rates (98% of sessions attended), mentoring questionnaire responses (M=49.4) and feedback describing the intervention as enjoyable and mentors as "nice," and "understanding." Participants and parents reported potential change in self‐efficacy for managing emotions (proximal outcome), use of coping strategies and self‐awareness of needs, but few changes in mental health symptoms (distal outcomes). Conclusions: The peer mentoring intervention was feasible and acceptable for young adults with intellectual and developmental disabilities and co‐occurring mental health conditions. Results suggest a longer intervention duration may be necessary to elicit changes in mental health symptoms. To enhance feasibility, different recruitment strategies should be considered. [ABSTRACT FROM AUTHOR]

Background: The COVID‐19 pandemic has significantly impacted family caregivers of adults with intellectual and developmental disabilities (IDD). This study evaluated a virtual course for family caregivers from across Canada, focused on supporting the mental health and well‐being of adults with IDD and their families. The evaluation examined the feasibility and acceptability of the course, as well as the impact of the intervention on participants' overall health and well‐being. Methods: The 6‐week virtual course, informed by a parallel Extension for Community Healthcare Outcomes (ECHO) course for service providers, combined didactic instruction with applied activities. A total of 126 family caregiver course participants consented to be part of the research evaluation delivered over three cycles between October 2020 and April 2021. Attendance was measured at each weekly session. Satisfaction was assessed weekly and post‐program. Learning, self‐efficacy, and well‐being were assessed pre‐ and post‐course, and again at follow‐up (8 weeks post‐course). Mixed‐effects models assessed changes between and within individuals across time. Results: Participants had consistent attendance, low‐dropout rates, and reported high satisfaction, with 93% of participants reporting that their expectations for the course were met. Compared with pre‐course, participants reported improved self‐efficacy and well‐being post‐course, which were maintained at follow‐up. Conclusions: An interactive and applied virtual education course delivered to a large group of family caregivers of adults with IDD was both feasible and acceptable. It positively impacted participants' well‐being by offering much needed mental health support and creating a peer‐led community of practice. [ABSTRACT FROM AUTHOR]

Background: Despite strong evidence for cognitive behaviour therapy (CBT) in treating mental health, its use, thus far, has been limited for people with intellectual disabilities. This study describes a CBT‐based guided self‐help (CBT‐GSH) manual for individuals with intellectual disability, and focus groups explore the views of clinicians, therapists, support staff and managers. Material and methods: Using a qualitative methodology, an expert team adapted the manual. Focus groups provided feedback, followed by thematic content analysis for modifications. Results: Participants supported using the manual, with varying views about the delivery. Quality of relationships and competence of the administrator determined the best person to deliver the treatment. Heterogeneity in the intellectual disability population was a challenge to delivering manual‐based interventions. Participants made suggestions about language and organization. Conclusions: Amendments were made to the manual in line with expert feedback. An evaluation is warranted to test for feasibility, delivery, acceptability and efficacy. [ABSTRACT FROM AUTHOR]

Intervention for behavioural and psychiatric disorders in people with intellectual disabilities often only takes place once these conditions are well established and more resistant to change. As an alternative, this paper promotes a public health prevention model and maps out opportunities for intervention at primary, secondary and tertiary levels. The resulting model is partly derived from generic research into these issues and partly on specific evidence on interventions for people with intellectual disabilities; it also contains more theoretical considerations. The additional research that is necessary to demonstrate the efficacy of the interventions identified is also considered. Central to this proposal is a greater integration of issues for people with intellectual disabilities within much broader policy and research agendas. [ABSTRACT FROM AUTHOR]

People with intellectual disabilities have poorer health than their non-disabled peers. They are also more likely to be exposed to a wide range of environmental adversities in childhood. Research undertaken in the general population has demonstrated that exposure to environmental adversity in childhood can have an adverse impact on health and well-being across the life course. Recently, research in this area has added new breadth and depth to our understanding of: (1) the extent to which cumulative exposure to environmental adversities across the life course, but especially in early childhood, can reduce health and well-being; (2) the social, psychological and biological mediating pathways through which environmental adversities may impair health; (3) the processes associated with resilience and vulnerability in the face of exposure to adversity; and (4) the social significance of these effects in accounting for the magnitude of the inequalities in health that are apparent both between and within populations. This new knowledge is making a significant contribution to the development of social policies that seek to combine health gain with the reduction in health inequalities. This paper attempts to apply this knowledge to research aimed at understanding and improving the health and well-being of people with intellectual disabilities. [ABSTRACT FROM AUTHOR]

Background: Based on self‐reported social capital, different typologies of family networks of people with intellectual disabilities were examined. Associations between behavioural and emotional problems or well‐being and typologies were investigated. Method: 137 participants with mild intellectual disability were interviewed using the Family Network Method‐Intellectual Disability to assess their emotionally supportive family relationships. Data on participants' well‐being and behavioural and emotional problems were also gathered. Latent class analysis was used to identify family typologies based on social network measures. Results: Four distinguishable typologies were identified, two supportive and two less supportive. A small association was found with behavioural and emotional problems and one of the supportive typologies. Associations with constructs of well‐being were found for both supportive and less supportive typologies. Conclusions: A variety of family types were found, with implications for sensitive professional support. [ABSTRACT FROM AUTHOR]

Background Patient experience of those accessing mental health services has been found to be different between ethnic groups. Although the needs of people with intellectual disabilities (ID) from different ethnic communities are being increasingly recognised, little has been published about their experiences of mental health services. The aim of this study was to establish whether there are any differences in the experiences of people with ID and mental health problems from two ethnic communities in South London. Method A two-round Delphi process was utilised. White British and Black or Black British service users from a specialist community-based mental health service for adults with ID completed a specially compiled questionnaire. Statements on participants' experiences, including satisfaction with care, staff members' attitudes, cultural awareness and level of support, were rated using a Likert scale. Results Twenty-four out of 32 participants (75%) completed both rounds of the Delphi consultation. Consensus (≥80% agreement with the group median) was reached for 20 items in the White group and five items in the Black group. All responses that reached consensus were positive about the services that were being received. The Black group were less positive about a range of their experiences, including the use of medication. Conclusions People with ID from two ethnic groups were able to successfully complete a Delphi consultation regarding their experiences of mental health services. Broad consensus on positive experiences of services was reached in the White group but not for the Black participants. [ABSTRACT FROM AUTHOR]

Accessible summary [ABSTRACT FROM AUTHOR]