Special edition: mental health and intellectual disabilities in Europe

Published date02 July 2018
Date02 July 2018
DOIhttps://doi.org/10.1108/AMHID-07-2018-069
Pages89-90
AuthorKen Courtenay
Subject MatterHealth & social care,Learning & intellectual disabilities
Ken Courtenay
Special edition: mental health and intellectual disabilities in Europe
Meeting the mental health needs of people with intellectual disabilities is a challengeto any health
care system. In this issue, various models ofcare from six countries in Europe are described with
the aim of learning from each other. The contributors provide insights from their personal clinical
and academic backgrounds often making reference to the work of colleagues in other countries
demonstratingthe awareness of how other modelsof practice can inform local practiceand policy.
The UK is recognized as a leader in developing and providing specialist mental health services for
people with ID but no one system can be assumed to have the perfect model. Providing mental
health care often depends on the social and political environments in which care is required.
Perera highlights the challenge of recruitment to MHID services and specialist social care support
in the community.
A theme in the papers is the move from institutional care to community services over the recent
40 years that has led to fragmented care in Norway as described by Bakken. Models of
community provision are not always clearly defined or universal as in Germany as Elstner and
Theil reflect where provision can depend on the interest and initiative of local providers.
Ramsay in Ireland highlights that change in MHID care can be slow in spite of the right
policies being in place. Leadership at a national level has been the lever to make change happen
in clinical services.
The funding of health care systems can affect the care people receive as reported from Germany
by Elstner and Theil and from Switzerland by Georgescu and Stryp von Rekowski. The flexibility
required to meet the health and social care of people with ID can hamper effective clinical care.
A recurring theme from all systems is the limited access to mental health care for people with ID
who are often treated in mainstream services. With the move to greater inclusion in society,
people with ID experiencing mental disorders are at risk of services not adequately meeting their
needs especially those with more severe levels of ID. Wieland highlights the needs of people who
do not meet the definitive criteria of ID but whose level of intellectual functioning would benefit
support from MHID services.
A workforce skilled in MHID is a key to provide high-quality services where they recognize the
presentation of mental disorders in people with ID and understand their needs. Specialist training
programs for clinicians exist in Ireland and the UK health services but not in other countries. In the
absence of specialist training, groups of dedicated practitioners have established supportive
clinical networks as in Switzerland and Germany to advance knowledge and practice in ID. Such
efforts are supported by links to professional associations such as the European Association for
Mental Health in Intellectual Disabilities and the Section of MHID of the European Psychiatric
Association with the aim of raising the profile of MHID and sharing learning and practice.
With the broad perspective on the state of mental health services for people with ID in six
countries in Europe in the issue, I hope we can learn from each other and pursue collaboration on
areas of mutual interest.
Running order
Perera and Courtenay Mental Health Services for People with Intellectual Disability in the UK.
Elstner and Theil The Health and Social Care of People with Disabilities in Germany.
Ken Courtenay is Consultant
Psychiatrist in Intellectual
Disability at Barnet, Enfield and
Haringey Mental Health NHS
Trust, London, UK.
DOI 10.1108/AMHID-07-2018-069 VOL. 12 NO. 3/4 2018, pp.89-90, © Emerald Publishing Limited, ISSN 2044-1282
j
ADVANCESIN MENTAL HEALTH AND INTELLECTUAL DISABILITIES
j
PAGE89
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