Services for People with Learning Disabilities and Mental Health Problems
| Date | 01 June 2000 |
| Pages | 5-14 |
| Published date | 01 June 2000 |
| DOI | https://doi.org/10.1108/13619322200000013 |
| Author | Mary Lindsey |
| Subject Matter | Health & social care |
Services for People with
Learning Disabilities
and Mental Health Problems
Mary Lindsey
Consultant in Learning Disability Psychiatry
Cornwall Healthcare Trust
Chair of the Faculty for the Psychiatry of Learning Disability
Royal College of Psychiatrists
Framework Feature
Policy background
In 1992 the Department of Health produced
guidelines for health services for people with learning
disabilities (Department of Health, 1992). These
guidelines were subsequently reinforced by the
good practice guidance Signposts for Success in
Commissioning and Providing Health Services for
People with Learning Disabilities (Lindsey, 1998). This
guidance stated that ‘people with learning disabilities
have the same rights of access to NHS services as
everyone else but may require assistance to use the
services. Special care must be taken to ensure that
they are not denied health care because of their
disability, and that steps are taken to ensure that any
barriers to access are minimised’. If their needs cannot
be met through the ordinary range of services then
special provision should be considered, including
alternatives to ordinary services and specialist
assessment and treatment centres. Therefore in
England the principles are clear – ordinary services
should be made as suitable as possible and specialist
services should be available as the ‘backstop’.
However, surveys have shown that this generally is not
the case.
Survey of services
A national survey of health and social care professionals’
views about local services for adults with learning
disabilities was carried out in 1994 (Gravestock &
Bouras, 1996). This showed that most mental health
services for adults with learning disabilities (66%)
were within learning disability services rather than
integrated within the general mental health services.
More respondents (62%) had established specialised
services (mainly assessment, treatment and community
support services) than had not (36%). Respondents
rated the general availability and accessibility of local
learning disability services for adults with learning
disabilities and mental health needs as significantly
better than generic mental health services. Most
respondents (94%) saw community learning disability
teams as the major local service provider for this group
but only 48% thought that such teams offered the
group with mental health needs adequate services.
A survey of NHS trusts in England and Wales was
undertaken in 1995 to ascertain the level of provision
of specialist learning disability health services (Bailey
& Cooper, 1997). Out of the 161 trusts that responded,
60.7% no longer had any long-stay beds in an institution
but the majority (70.4%) had short-term assessment
and treatment beds and also respite care beds (60.7%).
The survey also showed considerable variation in the
number of specialist professionals employed per
100,000 population. The trusts were also asked to
indicate their priorities for service development and
61 were developing new services for people with
challenging behaviour, while 27 were further
developing community services.
Issues of definition and prevalence
Conceptual models of disability and illness
The term ‘mental health problems’ is used here
because it is broad and generic and this is particularly
The Mental Health Review Volume 5 Issue 2 June 2000 ©Pavilion Publishing (Brighton) 2000 5
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