TY - JOUR
T1 - The Current Provision of Mental Health Services for Individuals with Mild Intellectual Disability
T2 - A Scoping Review
AU - Walton, Catherine
AU - Medhurst, David
AU - Madhavan, Giri
AU - Shankar, Rohit
N1 - Publisher Copyright:
© 2021 The Author(s). Published with license by Taylor & Francis Group, LLC.
PY - 2021/12/10
Y1 - 2021/12/10
N2 - Background: People with mild intellectual disability (ID) experience a higher prevalence of mental health (MH) problems in comparison to the general population, yet there is little consensus on the most appropriate type and nature of services for support and treatment for this specific group of individuals. Objective: The objective of this scoping review is to explore the current evidence for the organization, structure, and delivery of mental health services for people with mild ID. Methods: The PRISMA-SCr (Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews) checklist was followed. Online databases were used to identify systematic reviews, meta-analyses, scoping reviews, or guidelines published between 2003 and 2020. Articles were reviewed using Roever & Zoccai criteria for critical appraisal of systematic reviews and meta-analyses. Results: 130 records were identified, of which 91 were longlisted. Of these, 28 articles were shortlisted after review of abstracts prior to review of full-text papers. The review included 11 studies: one meta-analysis, eight systematic reviews, and two scoping reviews. These studies approached the provision of mental health services for individuals with mild ID from various angles–including service organization and access, therapies, and patient feedback. Conclusions: According to the Roever & Zoccai criteria, there was a lack of high-quality evidence, which limited the findings and conclusions. The available evidence suggested that despite higher levels of psychopathology there is not a corresponding consideration in care for individuals with mild ID in general psychiatric services. There was no conclusive evidence on better level of services or outcomes being provided either by the general psychiatric services or specialist ID psychiatric services. Some evidence was found for intensive case management and assertive outreach for individuals with mild ID, but this was not replicated in further studies. In terms of treatment, there was no high-quality evidence found for pharmacological interventions, with some limited evidence around psychological therapy for the treatment of depression in this vulnerable population. Overall, it was found that an increase in staff training would be beneficial in terms of timely access to services and appropriate treatment. There is a need for inclusive, evidence-based guidance as regards service development for people with mild ID and MH problems. Abbreviations: ID: intellectual disability; MH: mental health; CBT: Cognitive Behavioral Therapy; RCT: randomized controlled trial; ACT: assertive community treatment; ECT: electroconvulsive therapy.
AB - Background: People with mild intellectual disability (ID) experience a higher prevalence of mental health (MH) problems in comparison to the general population, yet there is little consensus on the most appropriate type and nature of services for support and treatment for this specific group of individuals. Objective: The objective of this scoping review is to explore the current evidence for the organization, structure, and delivery of mental health services for people with mild ID. Methods: The PRISMA-SCr (Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews) checklist was followed. Online databases were used to identify systematic reviews, meta-analyses, scoping reviews, or guidelines published between 2003 and 2020. Articles were reviewed using Roever & Zoccai criteria for critical appraisal of systematic reviews and meta-analyses. Results: 130 records were identified, of which 91 were longlisted. Of these, 28 articles were shortlisted after review of abstracts prior to review of full-text papers. The review included 11 studies: one meta-analysis, eight systematic reviews, and two scoping reviews. These studies approached the provision of mental health services for individuals with mild ID from various angles–including service organization and access, therapies, and patient feedback. Conclusions: According to the Roever & Zoccai criteria, there was a lack of high-quality evidence, which limited the findings and conclusions. The available evidence suggested that despite higher levels of psychopathology there is not a corresponding consideration in care for individuals with mild ID in general psychiatric services. There was no conclusive evidence on better level of services or outcomes being provided either by the general psychiatric services or specialist ID psychiatric services. Some evidence was found for intensive case management and assertive outreach for individuals with mild ID, but this was not replicated in further studies. In terms of treatment, there was no high-quality evidence found for pharmacological interventions, with some limited evidence around psychological therapy for the treatment of depression in this vulnerable population. Overall, it was found that an increase in staff training would be beneficial in terms of timely access to services and appropriate treatment. There is a need for inclusive, evidence-based guidance as regards service development for people with mild ID and MH problems. Abbreviations: ID: intellectual disability; MH: mental health; CBT: Cognitive Behavioral Therapy; RCT: randomized controlled trial; ACT: assertive community treatment; ECT: electroconvulsive therapy.
KW - access to services
KW - equality
KW - learning disability
KW - mental health services
KW - Mild intellectual disability
KW - policy
UR - http://www.scopus.com/inward/record.url?scp=85121384170&partnerID=8YFLogxK
UR - https://pearl.plymouth.ac.uk/context/pms-research/article/2171/viewcontent/19315864.2021.pdf
U2 - 10.1080/19315864.2021.1992549
DO - 10.1080/19315864.2021.1992549
M3 - Review article
AN - SCOPUS:85121384170
SN - 1931-5864
VL - 15
SP - 49
EP - 75
JO - Journal of Mental Health Research in Intellectual Disabilities
JF - Journal of Mental Health Research in Intellectual Disabilities
IS - 1
ER -