A survey of consultant psychiatrists in intellectual disability based in England
| Published date | 04 July 2016 |
| Pages | 258-270 |
| Date | 04 July 2016 |
| DOI | https://doi.org/10.1108/AMHID-03-2015-0012 |
| Author | Ashley Guinn,Sujeet Jaydeokar,Jane McCarthy,Ashok Roy,Angela Hassiotis |
| Subject Matter | Health & social care,Learning & intellectual disabilities |
A survey of consultant psychiatrists in
intellectual disability based in England
Ashley Guinn, Sujeet Jaydeokar, Jane McCarthy, Ashok Roy and Angela Hassiotis
Ashley Guinn is based at Policy
Unit, Royal College of
Psychiatrists, London, UK.
Sujeet Jaydeokar is based at
the Department of Intellectual
Disability, Barnet, Enfield, UK
and Haringey Mental Health
NHS Trust, Barnet, UK.
Jane McCarthy is based at
Department of Forensic and
Neurodevelopmental Sciences,
Institute of Psychiatry, King’s
College London, London,
UK and East London NHS
Foundation Trust, London, UK.
Ashok Roy is based at Coventry
and Warwickshire NHS Trust,
Coventry, UK and Faculty of
Psychiatry of Intellectual
Disability, Royal College of
Psychiatrists, London, UK.
Angela Hassiotis is based at
the Division of Psychiatry,
University College London,
London, UK and Camden
Learning Disability Service and
Camden and Islington
Foundation Trust, London, UK.
Abstract
Purpose –Community mental health services are of increasing importance for people with an intellectual
disability (ID), as the government aims to reduce the number of people treated within inpatient services.
However, due to limited evidence base, it is unclear which service models are most effective for treating
people with both ID and a mental health condition. Therefore, the purpose of this paper is to carry out a
survey in order to gain a better understanding of the current state of ID community services.
Design/methodology/approach –The survey was e-mailed to 310 consultant psychiatrists based in
England and whose main specialism was in ID. In total, 65 consultants responded to the survey with 53
complete data sets.
Findings –In total, 84 per cent of consultants identified themselves as working in a generic community ID
team. The majority of services were not integrated with social care (71 per cent). Regional differences were
found.In contrast to the rest of England, the majorityof services in London were integratedwith social care. The
Healthof the Nation Outcome Scalefor people with Learning Disabilities(HoNOS-LD)was found to be the most
common outcome measure used by services. A range of interventions are widely available across services
including psychological therapiesand specialist memory assessments. The surveyalso provides evidence for
increased decommissioning of specialist inpatient units anda need for more robust community services.
Research limitations/implications –Findings limited by low return rate (21 per cent) and because
responses could not be matched to specific services. The implications of this survey are that there is still a
variable level of integration with social care and that lack of integration could affect the quality of service. While
HoNOS-LD is used consistently across services, there may be a need to supplement it with other outcome
measures. There is a need for larger scale and higher quality studies in this area to strengthen the evidence
base and therefore demonstrate the benefits of integration and specialisation more convincingly to health
professionals and commissioners.
Originality/value –This survey presents an overview of the current state of community services for adults
with ID in England. This information can be harnessed to add to revised approaches to mental health service
models for people with ID.
Keywords Outcome measures, Intellectualdisability, Social care, Adult, Community mental health services,
Psychiatrist
Paper type Research paper
Introduction
A recent report on intellectual disability (ID) care has identified several problems in service
provision (Bubb, 2014). Due to failing to meet targets on reducing inpatient admissions for
people with ID and mental illness or challenging behaviour following transforming care
(Department of Health, 2012), community ID services are under increased pressure to reduce the
number of people being treated within inpatient services and help those who are discharged in
returning to their community of origin. Consequently, effective community mental health services
for this population are increasingly important. Despite this, there is currently a lack of consensus
Received 4 March 2015
Revised 3 March 2016
Accepted 18 April 2016
This project was supported by the
Faculty of the Psychiatry of
Intellectual Disability, Royal College
of Psychiatrists, 2014-2015.The
authors would like to thank the
Consultants who responded to the
survey, Kitti Kottasz for circulating
the survey and the support of the
Policy Unit of the Royal College of
Psychiatrists.
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VOL. 10 NO. 4 2016, pp.258-270, © Emerald Group Publishing Limited, ISSN 2044-1282 DOI 10.1108/AMHID-03-2015-0012
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