Does training adequately equip psychiatrists for intellectual disability?
| DOI | https://doi.org/10.1108/AMHID-07-2019-0020 |
| Published date | 12 February 2020 |
| Pages | 69-82 |
| Date | 12 February 2020 |
| Author | Geraldine Lines,Jodie Allen,Caryl Jane Marshall |
| Subject Matter | Health & social care,Learning & intellectual disabilities |
Does training adequately equip
psychiatrists for intellectual disability?
Geraldine Lines, Jodie Allen and Caryl Jane Marshall
Abstract
Purpose –People with intellectual disability (ID) experience significant health and social inequality
compared to their non-disabled peers. Individuals withID who access mental health services can have
complex comorbidities and presentations. In the UK, a significant proportion of individuals with ID are
supported within general adult mental health services not by specialist ID teams. The purpose of this
study is to explore whether psychiatry trainees in the Maudsley Training Programme (MTP) feel
adequatelyskilled to support individuals with ID.
Design/methodology/approach –An onlinesurvey of trainee psychiatrists in theMTP was completed to
evaluate self-perceivedskills and knowledge in the care of individuals withID in mental health services.
Statisticalanalysis of the results was completed.
Findings –Experience of workingin specialist ID teams is positively associated withgreater confidence
and skills among traineesin the care of people with ID; this is beyond what would be expected based on
seniorityalone.
Research limitations/implications –The response rate was 16.7per cent; a larger sample size would
add strengthto the study. Like all online surveys,there exists the risk of selection bias.
Practical implications –UK Policy states that people with ID should be supported to access
mainstream services wherepossible, including psychiatric care. Practical experience for all psychiatry
trainees involving specialist ID services and people with ID could improve the care given to that
particularlydisadvantaged group.
Originality/value –This is the only paperknown to the authors that has focused specificallyon the skills
and knowledgeof psychiatry trainees in the UK with regardsto ID.
Keywords Training, Disability, Psychiatry, Intellectual, Learning, Developmental
Paper type Research paper
Introduction
People with intellectual disability (ID) suffer from significant health inequalities (Hesl op
et al., 2013) and are especially vulnerable to iatrogenic harm (NHS England, 2016). The
UK is unique in that it has an accredited speciality in ID psychiatry, with its own Royal
College of Psychiatrists (RCPsych) ID Faculty. With the national emphasis on community
living since the 1990s, the Valuing People (Department of Health and Social Care, 2001)
services with reasonable adjustments, it is not acceptable to expect specialist ID
services alone to bridge the health-care gap. Most adults with ID will not meet the criteria
for assessment and treatment by an ID psychiatrist, whose service is commissioned to
see only the most complex cases. In fact, it is estimated that only a quarter of people with
ID diagnosed in childhood will access adult ID services (Hatton et al., 2016). It is
therefore important that all psychiatrists have sufficient knowledge and skills to assess
and treat ID patients with less complex presentations. This study specifically focuses on
doctors in psychiatry training (residents).
Geraldine Lines is based at
the King’s College London,
Institute of Psychiatry,
Psychology and
Neuroscience, London, UK;
Oxleas NHS Foundation
Trust, Kent, UK and Sussex
Partnership NHS
Foundation Trust, Worthing,
West Sussex, UK.
Jodie Allen is based at the
Salomons Institute of
Applied Psychology,
Canterbury Christ Church
University, Canterbury, UK.
Caryl Jane Marshall is
based at the South London
and Maudsley NHS
Foundation Trust, London,
UK and Oxleas NHS
Foundation Trust, Kent, UK.
Received 12 July 2019
Revised 10 November 2019
17 December 2019
Accepted 10 January 2020
The authors are grateful to
Reay Library, South London
and the Maudsley NHS
Foundation Trust and Dr Fergal
Jones, Research Director,
Salomons Institute for Applied
Psychology, Canterbury Christ
Church University.
Declaration: No research
funding. No conflicts of interest.
DOI 10.1108/AMHID-07-2019-0020 VOL. 14 NO. 3 2020, pp. 69-82, ©Emerald Publishing Limited, ISSN 2044-1282 jADVANCES IN MENTAL HEALTH AND INTELLECTUAL DISABILITIES jPAGE 69
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