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Using ‘candidacy’ as a framework for understanding access to mainstream psychological treatment for people with intellectual disabilities and common mental health problems within the English Improving Access to Psychological Therapies service
- Source :
- Journal of Intellectual Disability Research. 60:571-582
- Publication Year :
- 2016
- Publisher :
- Wiley, 2016.
-
Abstract
- 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.
- Subjects :
- Adult
Mental Health Services
030506 rehabilitation
medicine.medical_specialty
media_common.quotation_subject
Population
Health Services Accessibility
03 medical and health sciences
0302 clinical medicine
Arts and Humanities (miscellaneous)
Intellectual Disability
Intellectual disability
medicine
Humans
030212 general & internal medicine
Program Development
education
Psychiatry
Qualitative Research
Disadvantage
media_common
education.field_of_study
Medical education
Rehabilitation
Improving Access to Psychological Therapies
medicine.disease
Mental health
Psychotherapy
Psychiatry and Mental health
Negotiation
England
Neurology
Candidacy
Neurology (clinical)
0305 other medical science
Psychology
Qualitative research
Subjects
Details
- ISSN :
- 09642633
- Volume :
- 60
- Database :
- OpenAIRE
- Journal :
- Journal of Intellectual Disability Research
- Accession number :
- edsair.doi.dedup.....14cf2064120cfa2ebfc4f44a82d67fee