Mental health problems in people with learning disabilities

Mainstream mental health has dramatically shifted from the custodial hospitalised medical model of a hundred years ago to a holistic model of care in the community with a greater focus on community-based policies of inclusion and recovery. There has also been a significant increase and recognition across the Western world that people with learning disabilities can develop mental health problems. This growing momentum has now led to a number of governments developing specific learning disability policies and documents that highlight and target the mental health needs of this population (Department of Health DH 2001, Department of Health, Social Services & Public Safety DHPSS 2005). These policies target the mental health needs of this population as well as promoting positive mental health or emotional well-being. Mental health is a subjective state that can be observed to be based upon a fluctuating continuum where each person assesses their own internal strengths against the external events/stressors/demands placed upon them. However, for some people their feelings or emotions, thoughts or perceptions, way of thinking or reasoning, memory and behaviours are affected for an extended period of time affecting their daily activities of living. Therefore, when the person reports these signs and symptoms to their healthcare professional, they may be diagnosed with a psychiatric disorder. The person therefore moves along to the opposite end of the mental health continuum. This chapter provides the reader with a discussion of the advancements and achievements that have occurred in the care of people with learning disabilities who have mental health problems. Read Case Illustration 17.1 of Joan and reflect upon this woman’s story as you will be asked to answer a number of questions throughout this chapter regarding her mental health problem.