Intellectual disability and autism in adults influence psychological treatments for mental health comorbidities

Published date13 April 2023
Date13 April 2023
Subject MatterHealth & social care,Learning & intellectual disabilities
AuthorRachel Mills,Rajan Nathan,Paul Soper,Felix Michelet,Alex G. Stewart,Sujeet Jaydeokar
Intellectual disability and autism in adults
inuence psychological treatments for
mental health comorbidities
Rachel Mills, Rajan Nathan, Paul Soper, Felix Michelet, Alex G. Stewart and
Sujeet Jaydeokar
Purpose The purpose of the study was to examine whether there were differences in the provision of
non-pharmacological interventions based on the level of intellectual disability and the presence or
absence of autism. Mental health conditions are often underdiagnosed in adults with intellectual
disability and do not always receive psychological interventions as recommended by the National
Institute for Health and Care Excellent guidelines. To realise the national UK programme’s aim of
stopping the overuse of medications in people with intellectual disability, it is important that these
individuals have access to appropriate non-pharmacological interventions. The authors examined the
relationship between an individual’s level of intellectual disability and the presence or absence of
autism with access to relevant non-pharmacological interventions from specialist community
intellectual disability services.
Design/methodology/approach A cross-sectionalstudy of adultsaccessing four specialistintellectual
disabilityservices in North West Englandin 2019.
Findings There was a high prevalence of mental health comorbidity, even higher for autistic adults.
However,a relatively small percentage of thestudy population was receiving psychologicalinterventions.
The most frequentnon-pharmacological intervention was a positivebehaviour support plan, irrespective
of comorbidmental illnesses.
Research limitations/implications Not havingaccess to psychological interventions forthe treatment
of mental illness could result in poor health outcomes and increasing health inequalities. The study
highlights the need for developing psychological interventions, particularly for those with moderate to
severeintellectual disability and for those with associatedautism.
Originality/value This large sample study examined the relationship between intellectual disability
level andthe presence of autism with accessing psychologicalinterventions.
Keywords Learning disability, PBS, STOMP, Mental illness, Cognitive behavioural therapy,
Anxiety management
Paper type Research paper
Mental health conditions in individuals with intellectual disability are often overlooked and
underdiagnosed (Mental Health Foundation, 2016). Explana tions include problems applying
standard assessment approaches and falsely attributing the clinic al problems to the
intellectual disability rather than recognising possible comorbid men tal health diagnoses
(Reiss et al.,1982). In addition, people with an intellectual disability have a higher prevale nce
of concurrent mental health diagnoses than the general population (Cooper et al., 2007);
consequently, potentially diagnosable conditions are being lef t untreated (Mental Health
Foundation, 2016), with increased barriers to accessing hea lthcare and specialist services
(RCPsych, 2020). Overall, such individuals are more likely to have poor physical health, a
(Informationabout the
authorscan be found at the
end of this article.)
Received 10 December 2021
Revised 27 June 2022
Accepted 5 July 2022
©Rachel Mills, Rajan Nathan,
Paul Soper, Felix Michelet,
Alex G. Stewart and
Sujeet Jaydeokar. Published by
Emerald Publishing Limited.
This article is published under
the Creative Commons
Attribution (CC BY 4.0) licence.
Anyone may reproduce,
distribute, translate and create
derivative works of this article
(for both commercial and
non-commercial purposes),
subject to full attribution to the
original publication and
authors. The full terms of this
licence may be seen at http://
Ethical information. The study
was approved through the
Trust’s research ethics
approval process. Data was
extracted and anonymised
from the standard electronic
patient record system used in
routine clinical care. According
to the Health Research
Authority algorithm (see http://
research/), this study was not
defined as research, and
therefore, did not require
submission to the Integrated
Research Application System
(a single system for applying
for the permissions and
approvals for health and social
care/community care research
in the UK).
DOI 10.1108/AMHID-12-2021-0050 VOL. 17 NO. 2 2023, pp. 61-72, Emerald Publishing Limited, ISSN 2044-1282 jADVANCES IN MENTAL HEALTH AND INTELLECTUAL DISABILITIES jPAGE 61

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