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 Generic services for people with a mental handicap

1992 ◽  
Vol 16 (4) ◽  
pp. 212-213 ◽  
Author(s):  
Mary E. Nolan ◽  
G. Radakrishnan ◽  
John Lewis
Keyword(s):  
Mental Illness ◽  
Special Needs ◽  
Royal College ◽  
Behavioural Disorders ◽  
Mentally Handicapped ◽  
Policy Documents ◽  
Mental Handicap ◽  
Department Of Health ◽  
Comprehensive Service ◽  
Handicapped People

There has been much discussion on the most suitable services for mentally handicapped people with special needs such as additional mental illness or marked behavioural disorders. A number of policy documents have advocated the use of generic services as a matter of course, such as the All Wales Strategy (1983), while others have acknowledged a possible need for specialist input when such services are used e.g. Needs and Responses (Department of Health, 1989). In 1986 the Royal College of Psychiatrists stated that the psychiatric needs of this group required a specialised service and suggested that ideally this would be integrated with other psychiatric specialities as part of a comprehensive service.

scholarly journals Learning disability psychiatry – the future of services

2000 ◽  
Vol 24 (7) ◽  
pp. 247-250 ◽  
Author(s):  
J. M. O'Dwyer
Keyword(s):  
Mental Illness ◽  
General Population ◽  
Learning Disability ◽  
Psychiatric Disorders ◽  
The Future

Distinctions between mental illness and learning disability have existed since the last century (Pinel, 1801; Ireland, 1877). The conditions have been accepted as coexisting in the same individual since the beginning of this century (Kraepelin, 1902). More recent papers have investigated the frequency of their coexistence and concluded that most psychiatric disorders are more common in those with learning disability than the general population (Turner, 1989).

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 Facilitating moves into the community: a new mental health services initiative

1991 ◽  
Vol 15 (10) ◽  
pp. 654-654
Author(s):  
Rosalind Ramsay
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Mental Health Services ◽  
Health Services ◽  
Mentally Ill ◽  
District Health ◽  
Consultant Psychiatrist ◽  
Department Of Health ◽  
Health Authorities ◽  
The Government

Stephen Dorrell, the government Health Minister, has criticised the current “gross misallocation” of resources for patients with mental illness. The Department of Health estimates that more than half the district health authorities' budget of £1.5 billion for mental health services is still being channelled into the 90 remaining large specialist mental hospitals. There are now only 40,000 patients in such institutions. However, according to government calculations, a total of 2¼ million people in this country have a mental illness which is “serious enough” for them to need consultant psychiatrist care. All those sufferers from mental illness living in the community must make do with the remaining DHA budget. In other words, 98% of the mentally ill are supported by less than half the total resources allocated by districts for mental health services.

scholarly journals Priority clinic access or outreach to provide Sexual and Reproductive healthcare for people with mental illness?

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S346-S347
Author(s):  
Elizabeth Rose ◽  
Elana Covshoff ◽  
Rudiger Pittrof ◽  
Usha Kumar ◽  
Elizabeth Rose
Keyword(s):  
Mental Illness ◽  
Reproductive Health ◽  
Learning Disability ◽  
Sexual And Reproductive Health ◽  
Clinical Pathways ◽  
Health Centre ◽  
Community Outreach ◽  
Psychiatric Ward ◽  
People With Mental Illness

AimsTo compare two sexual and reproductive health (SRH) clinical pathways (a priority appointment at a mainstream SRH clinic versus assertive community outreach), and to explore how each improves access to care for people with psychotic mental illness, severe addictions and/or learning disability.MethodObservational, descriptive study of two clinical access pathways within SHRINE (Sexual and Reproductive Health Rights, Inclusion and Empowerment), a specialist SRH programme to improve SRH care for severely marginalised people.The SHRINE programme delivers effective, ethical, accessible and user-centred SRH care for people with severe addiction, serious mental illness and/or learning disability in the deprived inner London boroughs of Lambeth and Southwark. These individuals often find accessing conventional SRH clinics very difficult. SHRINE clients can self-refer but most of them are referred by their health or social worker.Clients or referrers indicate their preferred pathway: priority appointment at the mainstream clinic or assertive community outreach. The priority appointment pathway at Camberwell Sexual Health Centre (CSHC) is as flexible as possible, with minimal waiting times, reminders, invitation to bring a friend or care worker and active follow-up of non-attenders via key workers. Assertive community outreach can be in an addiction clinic, postnatal ward, mental health centre, psychiatric ward, outpatient clinic, homeless hostel or the client's home.Time allocation for outreach and priority appointment-based care was 8 and 4 hours per week respectively. Care in both pathways was provided by senior doctors. Content of care was similar but facility for provision of gynaecological care including cervical smears and investigations for abnormal uterine bleeding e.g. pelvic ultrasound scans and endometrial biopsies were only available in the mainstream clinic setting at CSHC.ResultFrom May 2016 to December 2020 SHRINE received 1367 referrals from 125+ teams. We offered 1591 first or follow-up appointments of which 1369 (86%) were attended. A total of 1153 (84%) of our patient contacts occurred in the outreach setting where 93% the appointments were attended. Of the 358 appointments at CSHC 316 (60%) were attended.ConclusionMaking clinic access as simple and convenient as possible is not a sufficient strategy to meet the SRH needs of marginalised people. To enable them to realise their human right to sexual and reproductive health we need to leave our clinics and meet our clients where they are. A combined model of outreach and priority access clinic pathways is essential for provision of SRH care for people with mental illness.

Sati

Crisis ◽  
2005 ◽  
Vol 26 (2) ◽  
pp. 73-77 ◽  
Author(s):  
Dinesh Bhugra
Keyword(s):  
Mental Illness ◽  
Psychiatric Disorders ◽  
Indian Subcontinent ◽  
Cultural Factors ◽  
Role Expectations ◽  
Prevention Strategies ◽  
Social Causation ◽  
Gender Role Expectations ◽  
Good Wife ◽  
And Gender

Abstract. Sati as an act of ritual suicide has been reported from the Indian subcontinent, especially among the Hindus, for several centuries. Although legally proscribed, these acts occur even now in modern India. The principle behind such acts has been put forward as the principle of good wife. There is little evidence to suggest that women who commit this act suffer from a formal mental illness. Cultural factors and gender role expectations play a significant role in the act and its consequences. Using recent examples, this paper illustrates the cultural factors, which may be seen as contributing to the act of suicide. Other factors embedded in the act also emphasize that not all suicides have underlying psychiatric disorders and clinicians must take social causation into account while preparing any prevention 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.

scholarly journals The use of computerised tomography in mental handicap patients

1992 ◽  
Vol 16 (10) ◽  
pp. 616-618
Author(s):  
S. K. Lekh ◽  
B. K. Puri ◽  
I. Singh
Keyword(s):  
Psychiatric Disorders ◽  
Research Tool ◽  
Clinical Neurology ◽  
Computerised Tomography ◽  
Chronic Schizophrenic ◽  
Mental Handicap ◽  
Schizophrenic Patients

Since its inception (Hounsfield, 1973), computerised tomography (CT) has become an invaluable diagnostic and research tool, particularly in clinical neurology and neurosurgery. Clinically, CT has proved useful in differentiating between ‘functional’ and ‘organic’ psychiatric disorders where it is particularly helpful in the diagnosis of potentially treatable organic disorders. For example, Owens et al (1980) found clinically unsuspected intracranial pathology in 12 of 136 chronic schizophrenic patients examined by CT and Roberts & Lishman (1984) found diagnosis, management, and/or prognosis were influenced in approximately 12% of cases referred by psychiatrists for CT imagining.

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