Avoiding delays in diagnosis: the importance of proactive liaison and education of staff in the general hospital
| DOI | https://doi.org/10.1108/AMHID-04-2014-0012 |
| Published date | 28 October 2014 |
| Pages | 399-402 |
| Date | 28 October 2014 |
| Author | Anna Walder,Robert Green,Sujata Soni |
| Subject Matter | Health & social care,Learning & intellectual disabilities,Accounting education |
Avoiding delays in diagnosis: the
importance of proactive liaison and
education of staff in the general hospital
Anna Walder, Robert Green and Sujata Soni
Dr Anna Walder is a CT3 in
Psychiatry, based at East
London NHS Foundation Trust,
London, UK.
Dr Robert Green is based at
Bartshealth NHS Foundation
Trust, London, UK.
Dr Sujata Soni is a ST5 in
Psychiatry of Intellectual
Disability, based at East
London NHS Foundation Trust,
London, UK.
Abstract
Purpose – The purpose of this paper is to illustrate the difficulties patients with intellectual disabilities face
when they present to a general hospital with ambiguous symptoms and highlights the importance of
adequate training for general staff in caring for people with learning disabilities.
Design/methodology/approach – The authors describe the pathway of a person with a learning disability
and mental health problems from A&E, through a general hospital, to discharge and the problems
encountered in terms of diagnostic clarity and subsequent treatment.
Findings – Delay in recognising a psychiatric cause for his symptoms and wrongly attributing his symptoms
to his learning disability may have led to a protracted admission and invasive tests.
Originality/value – Education of healthcare professionals and proactive liaison work can help improve
outcomes for people with intellectual disabilities when they are admitted to generic services.
Keywords Education, Hospital, Intellectual disabilities, Physical health, Liaison,
Diagnostic overshadowing
Paper type Case study
Introduction
It is widely acknowledged that people with intellectual disabilities receive poorer care when they
are admitted to hospital than the rest of the population and that they are much more likely to
require acute services on an unplanned basis (Michael and Richardson, 2008; CIPOLD, 2013).
The problems faced by people with intellectual disabilities accessing healthcare services include
discrimination, problems with communication and lack of staff training about the special needs
of people with intellectual disabilities in hospitals (Mencap, 1998).
In this case study of a young man with a mild learning disability and mental health problems we
describe his pathway through services following his presentation to an Accident and
Emergency department. We illustrate some of the difficulti es people with intellectual
disabilities face when they present to a general hospital with ambiguous symptoms. In this
case his family members’ interpretation of mental health symptoms influenced the history given
to the admitting clinicians. Once on a physical health ward access to liaison services can vary
greatly and it is therefore vital to ensure adequate training for all staff in generalhospitals whoare
involved in the care of people with intellectual disabilities.
Case history
H is a British born 19- year-old male of Bengaliorigin. He has a diagnosis of mild learning disability
and had previously received a diagnosis of bipolar affective disorder. His mother developed
gestational diabetes at seven months but the pregnancy and birth were otherwise uneventful.
DOI 10.1108/AMHID-04-2014-0012 VOL. 8 NO. 6 2014, pp. 399-402, CEmeraldGroup Publishing Limited, ISSN 2044-1282
j
ADVANCES IN MENTAL HEALTH AND INTELLECTUAL DISABILITIES
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PAGE 399
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