LEARNING DISABILITY , DEMENTIIA AND MENTAL HEALTH PROBLEMS

LEARNING DISABILITY

• Between 25 and 40% of people with learning disabilities also suffer from mental health problems
• These patients are 33 times more likely to be on the autistic spectrum and more likely than others to have emotional and conduct disorders
• Prevalence rates for schizophrenia in people with learning disabilities are approximately three times greater
• People with Down's syndrome are athigh risk of developing dementia, with an age of onset 30-40 years younger than the general populati

Challenging behaviours (aggression, destruction, self-injury and others) are shown by 10%-15% of people with learning disabilitie

The prevalence of dementia is much higher amongst older adults with intellectual disabilities compared to the general population

prevalence rates for anxiety and depression amongst people with learning disabilities vary widely, but are generally reported to be at least as prevalent as the general population

Children with intellectual disabilities are more likely to experience anxiety disorders (8.7% vs 3.6%) and conduct disorders (25.0% vs 4.2%) than children without intellectual disabilities, although rates for depression are
Similar

People with mental health problems and borderline intellectual functioning are particularly difficult to treat and people with intellectual disabilities are at risk of receiving no mental health service, due to the lack of communication between mainstream psychiatry services and intellectual disability psychiatry services

Psychiatric assessment of a person with an intellectual disability

assessment operate across four dimensions


Biological
Psychological
Social
Developmental

Conduct a full psychiatric assessment, including all the usual component parts

Full history (usual subheadings)
Collateral history
Mental state examination
Physical examination
Reviewing previous medical case notes
Discussion with professionals from other disciplines involved in the person's care

Additionally, special considerations are required during assessment

• Capacity to consent
• Communication and engagement
• Information from cares
• Development history(level of ability and causes of disabilities )

Communicating with a person with a learning disability

Allow plenty of time
Relaxed, familiar environment
Remove physical barrier
Comfortable seating
Positioning to allow communication with both the person and their carer
Noise-free environment
Active listening
Avoid jargon

DEMENTIA AND LEARNING DISABILITY

Increasing number of adults with a learning disability who are surviving in to older age has obvious implications in terms of prevalence rates for dementia, depression and other functional mental illnesses. People with Down’s Syndrome in particular are at high risk of developing Alzheimer’s Disease as they grow older.

There are many legal issues affecting older people with Dementia and Functional Mental Illness, for example consent and capacity, compulsory admission for assessment and treatment, management of financial affairs, issuing of advanced directivesl.

CONTINUITY OF CARE

person-centred, empowering reflective of the range of presenting needs and care preferences, holistic flexible in response responsive to changing needs locally delivered as far as possible as seamless as possible, offering continuity of care focused on achieving positive outcomes in terms of health and quality of life effectively monitored

People with learning disability who develop dementia should be enabled to access mainstream dementia services if that is their choice. Continuity of service provision for both the individual and their carer should be taken in to consideration. 'In-reach' expertise and support from the specialist team should be available in either case.

THANK YOU