Psychiatry and Learning Disability

1994 ◽  
Vol 164 (5) ◽  
pp. 613-618 ◽  
Author(s):  
Andrew H. Reid
Keyword(s):  
Mental Illness ◽  
Patient Care ◽  
Learning Disability ◽  
Medical Specialty ◽  
Mental Handicap ◽  
General Psychiatry ◽  
The University

My involvement with the psychiatry of learning disability began in 1968 when Professor Batchelor, then Professor of Psychiatry at the University of Dundee, suggested that mental illness in people with learning disability was a clinically interesting and under-researched topic which merited further investigation. At that time, mental illness was not usually considered even a part of the medical specialty of learning disability – or at least, not in Scotland. People in mental handicap hospitals who developed signs of mental illness were normally passed on to colleagues in general psychiatry who were considered to have the investigative and treatment expertise. If admission to in-patient care was considered necessary, it was usually to the local general psychiatry service.

scholarly journals In-patient care for people with a learning disability and a mental illness

1994 ◽  
Vol 18 (1) ◽  
pp. 29-31 ◽  
Author(s):  
John Hurst ◽  
Jay Nadarajah ◽  
Stuart Cumella
Keyword(s):  
Mental Illness ◽  
Mental Retardation ◽  
Patient Care ◽  
Learning Disability ◽  
Dual Diagnosis ◽  
Considerable Evidence

People with the dual diagnosis of mental illness and mental retardation have proved difficult to resettle from hospital. Yet there is considerable evidence that, if diagnosed correctly, treatment for such patients can be effective (e.g. Matson, 1981; Welch ft Sigman, 1980). This paper describes the outcome of treatment at a specialist unit for patients with dual diagnosis.

scholarly journals Developing local services for people with a learning disability and a psychiatric disorder

1993 ◽  
Vol 17 (4) ◽  
pp. 215-217 ◽  
Author(s):  
Ashok Roy ◽  
Stuart Cumella
Keyword(s):  
Mental Illness ◽  
Learning Disability ◽  
Psychiatric Disorders ◽  
Community Support ◽  
Psychiatric Ward ◽  
District Health ◽  
Mental Handicap ◽  
Department Of Health ◽  
Health Report ◽  
Support Team

Recent ministerial statements and health circulars have identified a key role for the NHS in providing services for people with a learning disability who have a mental illness or a severe behaviour disorder (NHS Management Executive, 1992). This is not an insignificant task, given that psychiatric disorders (including both mental illness and/or severe behaviour disorders) occur among approximately 30% of people with a moderate or severe learning disability (Corbett, 1979; Lund, 1985). Patients with psychiatric disorders have proved particularly difficult to resettle from mental handicap hospitals, and form a substantial proportion of the patients who become long-stay residents of mental handicap hospitals despite the development of community-based services. It is therefore essential that each district health authority defines the most appropriate pattern of services for this group of patients, as part of their purchasing strategy for mental health. The type of service required was discussed by the department of Health report Needs and Responses: Services for Adults with Mental Handicap who are Mentally Ill, who have Behaviour Problems, or who Offend. This noted that no consistent pattern of services has yet emerged, and that suitable alternatives included admission to a specialised mental illness unit in a mental handicap hospital, admission to a general psychiatric ward, admission to a small staffed house, or treatment by a community support team.

scholarly journals The Day House

1989 ◽  
Vol 13 (8) ◽  
pp. 415-417
Author(s):  
Ruth M. Walters
Keyword(s):  
Psychiatric Disorder ◽  
Patient Care ◽  
Psychiatric Disorders ◽  
Treatment Process ◽  
Conduct Disorders ◽  
Mental Handicap ◽  
Neurotic Disorders ◽  
General Psychiatry ◽  
Or Practice ◽  
Abstract Ideas

There is increasing recognition that people with a mental handicap who also suffer from psychiatric disorder will need specialised services. Those with major psychiatric disorders may need periods of hospital in-patient care but treatment as out-patients or day-patients may be more appropriate for those with neurotic disorders, behaviour or conduct disorders, problems of adjustment or personality problems. Many such psychiatric difficulties are amenable to treatment by therapies commonly used in general psychiatry. However, the treatment process can be prolonged and may need modifying so that there is always a ‘concrete’ or ‘practice’ base for handicapped persons who may have limited or no ability to conceptualise abstract ideas, although able to gain insight and modify their behaviour when taught appropriate skills and strategies.

Unfitness to Plead in England and Wales

2018 ◽  
Author(s):  
Rudi Fortson
Keyword(s):  
Mental Illness ◽  
Learning Disability ◽  
Developmental Disorder ◽  
Criminal Offence ◽  
Legal Process ◽  
England And Wales ◽  
Criminal Jurisdiction ◽  
Communication Impairment ◽  
The Law ◽  
Law Commission

This chapter examines the legal and practical issues encountered by practitioners when dealing with unfitness to plead litigation. As the Law Commission for England and Wales has pointed out, defendants charged with a criminal offence may be unfit to plead or to stand trial for a variety of reasons, including difficulties resulting from mental illness, learning disability, developmental disorder, or communication impairment. Two issues are considered: (i) how might those defendants who are unfit be accurately identified; and (ii) what steps should be taken by legal practitioners and by the courts of criminal jurisdiction to cater for the interests of vulnerable defendants, victims, and society, and to maintain the integrity of the legal process as one that is fair and just? The chapter evaluates the reform proposals of the English Law Commission and assesses how the law could be improved for all those who are involved in dealing with the unfit to plead.

The importance of upholding the duty of candour during patient care

2021 ◽  
Vol 30 (1) ◽  
pp. 74-75
Author(s):  
Alan Glasper
Keyword(s):  
Patient Care ◽  
Media Coverage ◽  
Emeritus Professor ◽  
The University

In light of recent media coverage, Emeritus Professor Alan Glasper, from the University of Southampton, discusses polices and guidance pertinent to the duty of candour

Strategies to boost the mental health and learning disability nursing workforce

2021 ◽  
Vol 30 (3) ◽  
pp. 194-195
Author(s):  
Alan Glasper
Keyword(s):  
Mental Health ◽  
Learning Disability ◽  
Nursing Workforce ◽  
Emeritus Professor ◽  
The University ◽  
Recent Policy

Emeritus Professor Alan Glasper, from the University of Southampton, discusses two recent policy reports which indicate a potential crisis in mental health and learning disability nursing

Determinants of somatization in primary care

1991 ◽  
Vol 21 (2) ◽  
pp. 473-483 ◽  
Author(s):  
K. Bridges ◽  
D. Goldberg ◽  
B. Evans ◽  
T. Sharpe
Keyword(s):  
Primary Care ◽  
Mental Illness ◽  
Patient Care ◽  
Social Stress ◽  
Psychological Symptoms

SYNOPSISThis study explores possible determinants of somatization in primary care. Hypotheses were tested on samples of ‘somatizers’, ‘psychologizers’ and controls recruited by epidemiological procedures. Although ‘somatizers’ were found to be similar to ‘psychologizers’ in many respects, they were (i) less depressed; (ii) reported lower levels of social dissatisfaction, social stress and less dependence on their relatives; (iii) more likely to have an unsympathetic attitude towards mental illness and less likely to consult a doctor about psychological symptoms, and (iv) more likely to have received medical in-patient care as an adult before they had consulted their doctor with their current illness. These findings are discussed in the context of previous research.

Learning disability and the Scottish Mental Health Act

2017 ◽  
Vol 11 (2) ◽  
pp. 74-82
Author(s):  
Heather Welsh ◽  
Gary Morrison
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Learning Disabilities ◽  
Mental Disorder ◽  
Learning Disability ◽  
Psychotic Disorders ◽  
Content Type ◽  
Mental Health Legislation ◽  
Scottish Government ◽  
Health Legislation

Purpose The purpose of this paper is to investigate the use of the Mental Health (Care and Treatment) (Scotland) Act 2003 for people with learning disabilities in Scotland, in the context of the recent commitment by the Scottish Government to review the place of learning disability (LD) within the Act. Design/methodology/approach All current compulsory treatment orders (CTO) including LD as a type of mental disorder were identified and reviewed. Data was collected on duration and type of detention (hospital or community based) for all orders. For those with additional mental illness and/or personality disorder, diagnoses were recorded. For those with LD only, symptoms, severity of LD and treatment were recorded. Findings In total, 11 per cent of CTOs included LD as a type of mental disorder. The majority of these also included mental illness. The duration of detention for people with LD only was almost double that for those without LD. A variety of mental illness diagnoses were represented, psychotic disorders being the most common (54 per cent). Treatment was broad and multidisciplinary. In all, 87 per cent of people with LD only were prescribed psychotropic medication authorised by CTO. Originality/value There has been limited research on the use of mental health legislation for people with learning disabilities. This project aids understanding of current practice and will be of interest to readers both in Scotland and further afield. It will inform the review of LD as a type of mental disorder under Scottish mental health law, including consideration of the need for specific legislation.

scholarly journals The origins and persistence of psychosurgery in the state of Iowa

2017 ◽  
Vol 43 (3) ◽  
pp. E8 ◽  
Author(s):  
Francis J. Jareczek ◽  
Marshall T. Holland ◽  
Matthew A. Howard ◽  
Timothy Walch ◽  
Taylor J. Abel
Keyword(s):  
United States ◽  
Mental Illness ◽  
The United States ◽  
State Mental Health ◽  
The State ◽  
Medical Community ◽  
State University ◽  
University Of Iowa ◽  
The University ◽  
Frontal Lobotomy

Neurosurgery for the treatment of psychological disorders has a checkered history in the United States. Prior to the advent of antipsychotic medications, individuals with severe mental illness were institutionalized and subjected to extreme therapies in an attempt to palliate their symptoms. Psychiatrist Walter Freeman first introduced psychosurgery, in the form of frontal lobotomy, as an intervention that could offer some hope to those patients in whom all other treatments had failed. Since that time, however, the use of psychosurgery in the United States has waxed and waned significantly, though literature describing its use is relatively sparse. In an effort to contribute to a better understanding of the evolution of psychosurgery, the authors describe the history of psychosurgery in the state of Iowa and particularly at the University of Iowa Department of Neurosurgery. An interesting aspect of psychosurgery at the University of Iowa is that these procedures have been nearly continuously active since Freeman introduced the lobotomy in the 1930s. Frontal lobotomies and transorbital leukotomies were performed by physicians in the state mental health institutions as well as by neurosurgeons at the University of Iowa Hospitals and Clinics (formerly known as the State University of Iowa Hospital). Though the early technique of frontal lobotomy quickly fell out of favor, the use of neurosurgery to treat select cases of intractable mental illness persisted as a collaborative treatment effort between psychiatrists and neurosurgeons at Iowa. Frontal lobotomies gave way to more targeted lesions such as anterior cingulotomies and to neuromodulation through deep brain stimulation. As knowledge of brain circuits and the pathophysiology underlying mental illness continues to grow, surgical intervention for psychiatric pathologies is likely to persist as a viable treatment option for select patients at the University of Iowa and in the larger medical community.

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