Mental health and challenging behaviour: an overview of research and practice
| DOI | https://doi.org/10.1108/20441281211261131 |
| Date | 07 September 2012 |
| Published date | 07 September 2012 |
| Pages | 249-258 |
| Author | Yogesh Thakker,Kunle Bamidele,Afia Ali,Angela Hassiotis |
| Subject Matter | Education,Health & social care |
Mental health and challenging behaviour:
an overview of research and practice
Yogesh Thakker, Kunle Bamidele, Afia Ali and Angela Hassiotis
Abstract
Purpose – The purpose of this article is to explore the current evidence base in understanding the
relationship between mental health and challenging behaviour in people with intellectual disabilities.
Design/methodology/approach – The article discusses how challenging behaviour is associated with
psychiatric disorders. Common aetiological factors between challenging behaviour and psychiatric
disorders and diagnostic issues are considered. The article ends with a review of the assessment and
management of challenging behaviour within the context of mental health.
Findings – Several studies have highlighted common aetiological factors that are responsible for
challenging behaviour and psychiatric disorders in people with intellectual disabilities, and although
there is an overlap in the symptoms, both are thought to be different phenomena. Treatment of the
psychiatric disorder should ameliorate the challenging behaviour, although a functional analysis of the
behaviour may still be required in order to understand the purpose of the behaviour. There is evidence
for a range of different treatment approaches.
Originality/value – The article will assist professionals working with people with intellectual disabilities
to understand the complex relationship between mental health and challenging behaviour. It also gives
guidance on principles of management of people with complex mental health and behavioural needs.
Keywords Intellectual disabilities, Psychiatric disorder, Mental illness, Challenging behaviour,
Mental health services
Paper type General review
Introduction
Behavioural problems are common among people with intellectual disability and various
labels have been used to describe them including ‘‘maladaptive behaviour’’ (Dawson et al.,
1998), ‘‘behavioural disorder’’ (Carvill and Marston, 2002) and more commonly,
‘‘challenging behaviour’’ (Emerson, 2001), which was originally used in Nor th America by
The Association for Severe Handicaps in the 1980s. Challenging behaviour is a socially
constructed and dynamic concept: in order for an individual’s behaviour to be viewed as
challenging, a judgement is made that the behaviour is dangerous, frightening, distressing
or annoying and that it is of such an intensity,frequency or duration as to threaten the quality
of life and/or the physical safety of the individual or others and is likely to lead to responses
that are restrictive, aversive or result in exclusion (Emerson, 2001; The Royal College of
Psychiatrists, 2007).
Challenging behaviour should not be considered as a problem associated with an individual
but should be regarded as the product of an interaction between the individual and their
environment. It may be an attempt by the individual, whether consciously or unconsciously,
to communicate that their needs are not being met. Thus, the frequency of challenging
behaviour can be reduced by services through the provision of flexible, proactive strategies
to support the needs of people with intellectual disabilities (The Royal College of
Psychiatrists, 2007).
DOI 10.1108/20441281211261131 VOL. 6 NO. 5 2012, pp. 249-258, QEmerald Group Publishing Limited, ISSN 2044-1282
j
ADVANCES IN MENTALHEALTH AND INTELLECTUAL DISABILITIES
j
PAGE 249
Yogesh Thakker is based at
The Hillingdon Hospital,
London, UK.
Kunle Bamidele is based at
Westminster Learning
Disability Partnership,
London, UK.
Afia Ali is MRC Clinical
Research Fellow and
Angela Hassiotis is Reader,
both at the Mental Health
Sciences Unit, University
College London,
London, UK.
To continue reading
Request your trial