Assertive Community Treatment for People With Mild Intellectual Disability or Borderline Intellectual Functioning and Mental Health Problems or Challenging Behavior: State of the Art and Implementation in the Netherlands

2018 ◽  
Vol 15 (4) ◽  
pp. 329-342 ◽  
Author(s):  
Laura J. Neijmeijer ◽  
Robert Didden ◽  
Henk L. I. Nijman ◽  
Hans Kroon
Keyword(s):  
Mental Health ◽  
Intellectual Disability ◽  
The Netherlands ◽  
Assertive Community Treatment ◽  
Challenging Behavior ◽  
Mental Health Problems ◽  
State Of The Art ◽  
Community Treatment ◽  
Mild Intellectual Disability ◽  
Borderline Intellectual Functioning

Awareness and accessibility of the Dutch mental health care system for people with borderline intellectual functioning or mild intellectual disabilities

2018 ◽  
Vol 12 (3/4) ◽  
pp. 114-120 ◽  
Author(s):  
Jannelien Wieland ◽  
Mascha ten Doesschate
Keyword(s):  
Mental Health ◽  
Health Care ◽  
The Netherlands ◽  
Mental Health Care ◽  
Intellectual Disabilities ◽  
Mental Health Problems ◽  
Intellectual Functioning ◽  
Content Type ◽  
Borderline Intellectual Functioning ◽  
High Prevalence

Purpose In The Netherlands, curative mental health care and supportive care for people with an intellectual disability (ID) are organised in separate domains. Prevalence of mental health problems is known to be high among people with borderline intellectual functioning (BIF) or mild intellectual disabilities (MID). By contrast, according to recent findings, prevalence of BIF and MID is high among patients in mental health care (17.5–58 per cent). In The Netherlands, a new quality standard of care (QSOC) on mental health care for people with BIF or MID is developed. It is designed to supplement existing guidelines on mental health care so that they can be used appropriately in people with BIF or MID and meant for use in both mental health care organisations (MHCO) as in organisations for ID care. To a large extent, the QSOC should describe the existing practice. This paper aims to discuss these issues. Design/methodology/approach To assess the existing practice in current mental health care for people with BIF or MID in The Netherlands, the authors examined the views and accessibility of MHCO on the mental health care for patients with and IQ<85. In addition, the authors reviewed published criteria for in- and exclusion of all 39 top clinical mental health care departments for criteria on BIF or (mild) ID. Findings The authors found there is a clear awareness of the high prevalence of BIF and MID among large Dutch MHCO. Dutch MHCO estimate the prevalence of BIF and MID among their patients to be around 30 per cent. Nonetheless, most MCHO surveyed (76 per cent) indicated they do not routinely estimate or measure IQ among their patients and 53 per cent of MHCO indicated not having knowledge and expertise on the dual diagnoses of mental health problems and BIF or MID. Fitting in with the new QSOC most of the MHCO (59 per cent) agreed on the statement in the survey that professionals should be able to treat patients with BIF or ID and all but one of the MHCO stated to have some form of collaboration with an institute for ID care. Originality/value The authors concluded there is a clear awareness of the high prevalence of BIF and MID among large Dutch MHCO. The new QSOC on mental health care for people with BIF or MID can help improve accessibility and quality of mental health care for these patients.

Intellectual disability (mental retardation)

2017 ◽  
pp. 485-512
Author(s):  
Paul Harrison ◽  
Philip Cowen ◽  
Tom Burns ◽  
Mina Fazel
Keyword(s):  
Mental Health ◽  
Mental Retardation ◽  
Intellectual Disability ◽  
Intellectual Disabilities ◽  
Mental Health Problems ◽  
Fragile X ◽  
Mild Intellectual Disability ◽  
Assessment And Treatment ◽  
The Life Course ◽  
Challenging Behaviours

‘Intellectual disabilities’ covers the life course, with a focus on the assessment and treatment of the intellectual disabilities at younger ages. This chapter outlines current understanding of the aetiology of the more common intellectual disabilities. The clinical features are discussed for severe/profound, moderate, and mild intellectual disability, and the more common psychiatric presentations for those with intellectual disabilities. Mood disorders, anxiety disorders, and dementia are discussed in greater detail, as are the more common presentations of intellectual disability, with sections on Down’s syndrome and fragile X. The importance of prevention of mental health problems and better understanding and management of more challenging behaviours are discussed alongside other treatments for psychiatric disorders.

scholarly journals Specialisation and marginalisation: how the assertive community treatment debate affects individuals with complex mental health needs

2013 ◽  
Vol 37 (11) ◽  
pp. 345-348 ◽  
Author(s):  
Alan Rosen ◽  
Helen Killaspy ◽  
Carol Harvey
Keyword(s):  
Mental Health ◽  
Assertive Community Treatment ◽  
Mental Health Problems ◽  
Health Needs ◽  
Community Treatment ◽  
Mental Health Needs ◽  
Crisis Resolution ◽  
Patient Pathways ◽  
National Implementation ◽  
Collaborative Working

SummaryThe growth of specialism in a field can be considered a healthy response to emerging evidence, technology and skills, yet it risks creating unhelpful barriers to collaborative working and fragmented patient pathways. Mental health services in England have experienced this tension in recent years through the national implementation of local specialist community teams that aim to reduce the need for in-patient admission through a focus on crisis resolution, early intervention and assertive community treatment (ACT). In response to the results of studies assessing its effectiveness, there has been disinvestment in ACT. This risks marginalising people with severe and complex mental health problems by depriving them and their families of the intensive support they need for successful community living, as well as discouraging researchers from undertaking further high-quality studies that can inform the intelligent evolution of the ACT model within different contexts.

Met and unmet needs among adults with mild to moderate intellectual disability with and without mental health problems

2020 ◽  
Author(s):  
Matthias Schützwohl
Keyword(s):  
Mental Health ◽  
Intellectual Disability ◽  
Unmet Needs ◽  
Mental Health Problems ◽  
Psychiatric Symptoms ◽  
Health Problems ◽  
Service Planning ◽  
Support Needs ◽  
Behaviour Problem ◽  
Prevalence Rates

Background: People with an intellectual disability (ID) show a great number and complex constellation of support needs. With respect to the planning of services, it is important to assess needs at the population level. ID services need to know to what extent support needs of clients with mental health problems differ from support needs of clients without any mental health problem.Aims: The aim of this study was to compare the prevalence rates of needs in relevant study groups. Methods: Data was generated from the MEMENTA-Study (“Mental health care for adults with intellectual disability and a mental disorder”). The Camberwell Assessment of Need for Adults with Intellectual Disabilities (CANDID) was used to assess met und unmet support needs. Data was available for n=248 adults with mild to moderate ID.Results: Mean total number of needs and unmet needs was associated with mental health status. However, in most particular areas under study, individuals without significant psychiatric symptoms or any behaviour problem needed as much as often help as individuals with such mental health problems. A higher rate of need for care among study participants with significant psychiatric symptoms or any behaviour problem was mainly found with regard to these specific areas (“minor mental health problems”, “major mental health problems”, “inappropriate behaviour”) or with regard to closely related areas (“safety of others”).Conclusions: Differences in prevalence rates mainly occurred in such areas of need that rather fall under the responsibility of mental health services than under the responsibility of ID services. This has implications for service planning.

scholarly journals Is social camouflaging associated with anxiety and depression in autistic adults?

2021 ◽  
Vol 12 (1) ◽  
Author(s):  
Laura Hull ◽  
Lily Levy ◽  
Meng-Chuan Lai ◽  
K. V. Petrides ◽  
Simon Baron-Cohen ◽  
...  
Keyword(s):  
Mental Health ◽  
Intellectual Disability ◽  
Social Anxiety ◽  
Online Survey ◽  
Mental Health Problems ◽  
Autistic Traits ◽  
Health Problems ◽  
Autistic People ◽  
Autistic Adults ◽  
Anxiety Depression

Abstract Background There is inconsistent evidence for a clear pattern of association between ‘camouflaging’ (strategies used to mask and/or compensate for autism characteristics during social interactions) and mental health. Methods This study explored the relationship between self-reported camouflaging and generalised anxiety, depression, and social anxiety in a large sample of autistic adults and, for the first time, explored the moderating effect of gender, in an online survey. Results Overall, camouflaging was associated with greater symptoms of generalised anxiety, depression, and social anxiety, although only to a small extent beyond the contribution of autistic traits and age. Camouflaging more strongly predicted generalised and social anxiety than depression. No interaction between camouflaging and gender was found. Limitations These results cannot be generalised to autistic people with intellectual disability, or autistic children and young people. The sample did not include sufficient numbers of non-binary people to run separate analyses; therefore, it is possible that camouflaging impacts mental health differently in this population. Conclusions The findings suggest that camouflaging is a risk factor for mental health problems in autistic adults without intellectual disability, regardless of gender. We also identified levels of camouflaging at which risk of mental health problems is highest, suggesting clinicians should be particularly aware of mental health problems in those who score at or above these levels.

scholarly journals Assertive Community Treatment in the Netherlands: Outcome and Model Fidelity

2011 ◽  
Vol 56 (3) ◽  
pp. 154-160 ◽  
Author(s):  
Maaike D van Vugt ◽  
Hans Kroon ◽  
Philippe A E G Delespaul ◽  
Fred G Dreef ◽  
Annet Nugter ◽  
...  
Keyword(s):  
The Netherlands ◽  
Assertive Community Treatment ◽  
Community Treatment ◽  
Model Fidelity
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