This document discusses increasing access to psychological therapies for people with learning disabilities. It notes that mental health problems and psychological distress are more common in those with learning disabilities, with estimated prevalence being 30-50%. However, their mental health needs often go unrecognized and unmet. The document examines key Scottish policy documents and the IAPT program in England to improve access to psychological therapies. It discusses evidence for using therapies like CBT for those with learning disabilities, but notes barriers to meeting their mental health needs, including a lack of standardized assessment tools, limited training and knowledge, and time constraints. The conclusion emphasizes the need for more training, standardized assessments, and an evidence base to guide practice.
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Increasing access to psychological therapies for people with a learning disability
1. Increasing access
to psychological
therapies for
people with a
learning disability
Fleur-Michelle Coiffait
University of Edinburgh & NHS Lothian
Monday, 14 May 2012
3. LD and mental health
MH problems and distress
more common in this group
(Dosen & Day, 2001; Haddock & Jones, 2006; Brown & Marshall, 2006)
Estimated prevalence
30-50% (Smiley, 2005)
MH needs continue to be
unrecognised and unmet
LD services need to follow
mainstream mental health
services (Hatton & Taylor, 2005)
Monday, 14 May 2012
12. IAPT south of the border
贈173 million invested
2007 - 2011
IAPT primary care
services
Low / high intensity
therapists
Work at de鍖ned steps
Monday, 14 May 2012
14. IAPT and learning disabilities
Inclusion, improving
access for minorities
Monday, 14 May 2012
15. IAPT and learning disabilities
Inclusion, improving
access for minorities
Service
commissioning for
whole community
Monday, 14 May 2012
16. IAPT and learning disabilities
Inclusion, improving
access for minorities
Service
commissioning for
whole community
Overcoming health
inequality in NHS
services
Monday, 14 May 2012
17. IAPT and learning disabilities
Inclusion, improving
access for minorities
Service
commissioning for
whole community
Overcoming health
inequality in NHS
services
the reality?
Monday, 14 May 2012
18. Scottish policy context
Delivering for Mental Health (2006)
The Matrix (2008)
Adults
Children, young people, families
Long-term conditions
Physical health
Monday, 14 May 2012
19. Scottish policy context
Delivering for Mental Health (2006)
The Matrix (2008)
Adults
Children, young people, families
Long-term conditions
Physical health
where is LD?
Monday, 14 May 2012
20. Psychological therapies for
people with LD
The unoffered
chair (Bender, 1993)
Growing evidence
base for CBT (Beail, 2003)
Multidisciplinary
biopsychosocial
formulation (Ingham et al., 2008)
Behavioural family
therapy
Monday, 14 May 2012
21. Psychological therapies for
people with LD
The unoffered
chair (Bender, 1993)
Growing evidence
base for CBT (Beail, 2003)
Multidisciplinary
biopsychosocial
formulation (Ingham et al., 2008)
Behavioural family
therapy
why not?
Monday, 14 May 2012
22. Stepped care in LD services
Already used?
Feasible?
How would it work?
How would it look?
Skills gaps?
Training / supervision
needs?
Alternatives?
Monday, 14 May 2012
23. Methodology
2 x 45 min focus
groups
Ps CLDT:
psychiatrist, 4 x
nurses, SLT, OT,
physio, team secretary
Audio recorded and
transcribed verbatim
Process notes
Stimulus material and
topic guide
Monday, 14 May 2012
24. Topic guide
Recognition/
assessment
of MH / needs
How these needs are
met
Understanding / use of
approaches
Supervision, training
Stepped care
Monday, 14 May 2012
25. Data and analysis
90 mins discussion,
>16,000 words
Transcribed in full
NVivo 8 used for
coding and
organising thoughts
Thematic analysis
Monday, 14 May 2012
26. Thematic map
Lack of Barriers to Varying levels
standard recognising of knowledge
Lack of
assessment mental health and training
standardised
protocol / tool needs
procedure /
Lack of
tool
structured, Barriers to Time
evidence- meeting constraints
based mental health
approaches needs
Supervision Not enough
Fire鍖ghting
issues people to do it
Monday, 14 May 2012
27. Conclusions
Differing levels of MH /
knowledge, training,
experience and
con鍖dence
Lack of standardised
assessment tools/
protocols
Limited evidence base
limited training/
guidelines/ policy
available
Monday, 14 May 2012
28. Acknowledgements
North East
Edinburgh CLDT
Keith Marshall,
CBT Therapist in LD
Monday, 14 May 2012
29. Thanks for
listening
息 Luc Coiffait Photography
kindly provided by www.luccoiffait.com
Monday, 14 May 2012