Psychiatry of Learning Disability
Nature of the work
People with learning disability have higher
rates of mental health problems than the general population,
because they experience more biological and psychosocial risk
factors. Specialist psychiatrists working with this
population not only offer treatment for severe mental illness, but
also for a wide range of other mental and physical health problems
such as autistic spectrum / other neurodevelopmental
disorders and epilepsy. People with learning disability
may have fewer internal resources to cope with mental distress.
As a consequence more minor disorders can have a severe
effect, so services usually have a much lower threshold for
referral than mainstream mental health services.
Working in psychiatry of learning disabilities
Psychiatrists working with people who have
a learning disability need to have a wide range of clinical
skills. The clinical work is often made more complex and
interesting by concurrent physical problems such as epilepsy and
cerebral palsy; along with communication problems and challenges in
accessing services. People often present
non-specifically (for example with withdrawal or behaviour
problems) and finding out the cause is a fascinating diagnostic
challenge. Working with other disciplines can really help
with this process. It is also essential to consider the
system around the person (such as family, support staff) to
understand clinical problems and deliver effective
interventions.
Common procedure / interventions
Services for people with learning disability have been in the
vanguard of delivering integrated community care, and models such
as supported living and person centred planning have brought
substantial improvements to people’s quality of life. Most
specialist mental healthcare for people with learning disability is
delivered in community settings, but for those in need of inpatient
admission people with mild learning disability and mental illness
usually use mainstream inpatient beds, with specialist inpatient
facilities provided for people with forensic needs, and people with
more severe learning disability and challenging behaviour. A
wide variety of treatments are available, as in mainstream
psychiatry, including pharmacology, psychological (including
psychotherapy) social and educational interventions.
Associated subspecialties
Psychiatry of learning disability is a
fascinating academic discipline, whether you are interested in the
biological basis of mental health problems (e.g. dementia in people
with Down’s syndrome, behavioural phenotypes of genetic disorders),
or the development of innovative service models. Within the
specialty there are further subspecialties including Child and
Adolescent and Forensic. Much work has been done in recent
years in applying psychotherapeutic and systemic approaches to
working with people with learning disability. There are a
several high profile academic centres around the country.
Further information
Just click the buttons below for more information