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Intellectual disability and mental health disorders constitute a major health problem globally with higher economic burden in low- and middle-income countries such as Bangladesh. In 2017, the World Bank estimated that 85% of the global population lived in low-middle-income countries. Limited research has explored health practitioner knowledge and/or confidence in the diagnosis and treatment of mental health issues in persons with intellectual disabilities (IDs) in low-income countries such as Bangladesh. One hundred and ninety-seven Bangladeshi-based health practitioners were grouped into 7 main professional groups according the current Bangladeshi health hierarchy (psychiatrists; traditional healers and community workers; medical doctors; nurses; psychologists; allied health: speech therapists, occupational therapists, social workers; and others: teachers physiotherapists, administration staff). A 34-item online survey was completed, which included questions measuring symptoms of common mental health disorders with reference to the Psychiatric Assessment Schedule for Adults with Developmental Disabilities, and questions measuring confidence working with persons with IDs from the Therapy Confidence Scale-Intellectual Disabilities. Participants demonstrated low knowledge of symptomology but were "confident" working with people with IDs. Kruskal–Wallis H tests indicated a significant effect of professional group on both overall knowledge and confidence levels, respectively. Traditional healers and community health workers had significantly more knowledge of symptoms than all other practitioners for obsessive-compulsive disorder, depression, psychosis, and hypomania. Participants demonstrated confidence, but low knowledge, in treating individuals with IDs. The development of training programs to address specific deficits in knowledge of mental health symptoms, and confidence in using assessment and assessment-based communication, is recommended. [ABSTRACT FROM AUTHOR]

Many people with intellectual disability experience digital inequality due to a lack of Internet access; this is known as the digital divide. Digital inequality is also apparent when people with intellectual disability have Internet access, but only use it for a small number of applications (e.g., watching videos and playing games). Recently, it has been suggested that digital inequality also occurs in situations where some Internet users are less likely than others to translate their online activities to offline resources, including educational outcomes and social capital. The extent to which people with intellectual disability are translating their online activities to offline resources has not been examined. We conducted a systematic and critical review using PRISMA guidelines. The search strategy terms "intellectual disability" and "Internet use" were used to search the databases: Scopus; Wiley Online Library; Psychiatry Online; Web of Science; CINAHL; and PubMed. Twenty-four studies were found, which described 53 types of Internet use, 48 risks of Internet use, and 28 benefits of Internet use. The data were identified thematically and categorized to facilitate comparisons. The most frequently reported types of Internet use were in the category of social media/social networking (23%), the most common Internet risks were in the category of emotional distress (24%), and the most often reported benefits were in the category of friendships and social connection (33%). The findings indicate that the benefits of Internet use for people with intellectual disability have received much less attention than the risks. [ABSTRACT FROM AUTHOR]

Background: There is limited Australian research investigating health practitioner knowledge and/or confidence in the diagnosis and treatment of mental health disorders in people with intellectual disabilities (IDs). Method: Ninety-three health practitioners from four professional groups (primary health practitioners, psychologists, mental health practitioners, and alternative therapies) completed a 34-item online survey comprising questions designed to identify participant knowledge of disorders described in the Psychiatric Assessment Schedule for Adults with Developmental Disabilities and the Therapy Confidence Scale-Intellectual Disabilities. Results: Participants demonstrated low knowledge of symptomology and were "moderately confident" to "confident" working with people with IDs. Whilst professional group showed a significant main effect on confidence levels, post-hoc analysis did not detect significant differences between the individual professional groups. Conclusions: Australian participants demonstrated confidence, but low knowledge, in treating individuals with IDs. The development of training to address deficits in practitioner knowledge of symptomology, assessment, and assessment-based communication is recommended. [ABSTRACT FROM AUTHOR]

People with an Intellectual Disability (ID) are around 4 times more likely to suffer with a mental health disorder than IQ-typical people, however previous studies have shown they may be less likely to be diagnosed. One suggested cause of this is the diagnostic overshadowing bias: the tendency for practitioners to attribute unusual behaviour, thoughts or feelings to a person's ID and not a separate mental health disorder. In the current study N = 87 participants were randomly assigned 1 of 2 clinical vignettes describing a client who is displaying symptoms of mental health disorder. Vignette 1 described a client with an IQ of 105 who graduated from high school. Vignette 2 described a client with an IQ of 55 who attended special classes throughout school. All other details were identical. Participants then rated the likelihood of 7 diagnoses on a 5-point Likert scale. Contrary to our hypothesis participants were not less likely to diagnose a mental health disorder in people with an ID and this was found to exist across all profession types involved in the study. Although these findings indicate that the diagnostic overshadowing bias may not be present in Australia, several factors including a reported lack of confidence in working with clients with an ID suggest the inclusion of ID specific training may be beneficial. [ABSTRACT FROM AUTHOR]

Purpose The purpose of this paper is to summarise the initial experiences of Australia’s National Disability Insurance Scheme (NDIS). It highlights some of the main challenges being faced by participants, service providers and government, and demonstrates how research can contribute to the ongoing implementation and success of the scheme.Design/methodology/approach The historical basis for the need for a new approach to disability funding in Australia is explored. The opportunities that exist and the difficulties that are being encountered by those entering and working within the new scheme are discussed.Findings Several problems were identified including difficult transitions between existing support frameworks to new “NDIS plans”, and the risk of market failure. Both the problems and their solutions are discussed and it is hoped that collaboration between the Commonwealth Government, service users, their families, service providers and universities can lead to a number of lasting improvements.Practical implications The new funding framework provides exciting opportunities for increasing the funding of people with intellectual and physical disabilities in Australia. Developments in technology, service provision in rural and remote areas and the opportunity to meet aspirational life goals exist alongside a number of challenges, including the need to ensure that those with multiple and complex disabilities retain existing levels of support.Originality/value The implementation of the NDIS is still underway, and opportunities exist to implement changes to the scheme where required. Research findings have an important role to play in the national debate regarding how best to improve quality of life for people with a disability in Australia. [ABSTRACT FROM AUTHOR]

Measuring psychological change in offenders with intellectual disabilities undergoing psychological therapy presents the clinician with a variety of challenges. They include finding measures sensitive enough to measure the often modest cognitive changes that take place over the course of psychological therapy and finding measures appropriate to use with this client group. Little is known about the use of alcohol in offenders with intellectual disabilities. Repertory grids, based on Kelly's (1955) theory of personality, have been shown to be an adaptable, sensitive, reliable and valid measure of psychological change. Two case examples are used to show how repertory grids can be used to assess the treatment gains made by patients undergoing different (though similar) psychological interventions aimed at reducing alcohol misuse. [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]