Editorial
| Pages | 2-2 |
| Date | 01 June 2000 |
| Published date | 01 June 2000 |
| DOI | https://doi.org/10.1108/13619322200000011 |
| Author | Elizabeth Parker |
| Subject Matter | Health & social care |
Editorial
Elizabeth Parker
Editor
his issue of the Mental Health Review
focuses on services for learning disabled people who
also suffer from mental illness. Learning disability, the
most common form of disability in Britain affecting
around 1.2 million people, is a life-long condition
which is often associated with other impairments
including mental disorder. Those who are both learning
disabled and mentally ill are twice disadvantaged and
are likely to suffer an even greater degree of social
exclusion. The challenge facing services is how best to
meet the health and social care needs of this doubly
disabled group.
Bill Robbins, in a Personal Perspective, draws on
his own experience to reach conclusions about services
for learning disabled people with mental illness which
support the ‘normalisation’ policy and which are
examined further by the other contributors. He also
tackles the use of the term ‘dual diagnosis’ and
observes that in the learning disability services it
refers to people with a learning disability and a mental
illness but elsewhere it tends to refer to mental illness
combined with substance misuse – a source of confu-
sion when it is used in the unfamiliar context.
The Framework Feature, written by Mary
Lindsey, chair of the faculty for the Psychiatry of
Learning Disability at the Royal College of
Psychiatrists, gives an authoritative and comprehensive
overview of the issues involved in providing services
for this type of patient.
Government policy is that people with learning
disabilities should have the same right to NHS
services as the rest of the population. However,
following the closure of the institutions where many
learning disabled people with mental illness were
previously cared for, it is not clear how this ‘equal right
of access’ is to be achieved and Dr Lindsey concludes
that further work is needed to identify proven and
effective forms of service, whether generic mental
health services, or specialist services, or some
combination of the two.
The case studies depict two very different
initiatives to provide the services required. Nick
TBouras describes the setting up and operation of the
Estia Centre which aims to bring together clinical
services, training and research for people with mental
health needs and/or learning disabilities or challenging
behaviour. The acknowledgement of the split between
practice and research, the growing demand for
evidence-based interventions, and the need to ensure
that staff have the necessary skill and expertise were
the factors leading to the Centre being established.
In complete contrast, the Judith Trust originated
from one family’s experience of a learning disabled
sister who is also mentally ill. Annette Lawson gives a
graphic and moving account of her sister’s experiences
and changing needs at different periods of her life
which led to the establishment of the Trust. The aim
of the Judith Trust is to ‘plug the gaps in services that
seem too often unable to reconcile the fact that a
person who has limited intellectual ability will also
have emotional needs and frequently serious mental
illness’ and Dr Lawson describes its work to date.
As far as possible services for people with mental
health and/or learning disability needs are to be
community based and Sheila Hollins portrays in some
detail the problems in operating such a service. Her
conclusions echo those of Dr Lindsey and Professor
Bouras: more research and the application of research
findings to clinical practice.
Finally, turning to the context in which services
are delivered, Alison Giraud-Saunders and Rob Greig
examine different types of trust configuration and the
extent to which they facilitate the provision of services
for learning disabled and mentally ill people. After
setting out the pros and cons of each type of model
they conclude that there is no ‘best buy’.
For those of you involved in commissioning and
providing services for learning disabled people with
mental illness, this issue of the Review brings you the
‘state of the art’ information and thinking from the
leading figures in the field and will, I hope, both
clarify the issues involved and promote the provision,
in partnership, of effective services drawn from both
learning disability and mental health services.
2The Mental Health Review Volume 5 Issue 2 June 2000 ©Pavilion Publishing (Brighton) 2000
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