How does front-line staff feel about the quality and accessibility of mental health services for adults with learning disabilities?

Services for people with learning disabilities have been transformed since the late 1960s have been transformed since the late 1960s by the move from institutional to community by the move from institutional to community care. (Learning disabilities is the term care. (Learning disabilities is the term currently used in the UK in preference to currently used in the UK in preference to mental retardation, developmental dis-mental retardation, developmental disabilities and mental handicap.) Important abilities and mental handicap.) Important changes include the progress towards changes include the progress towards integration, participation, inclusion and integration, participation, inclusion and choice for people with learning disabilities, choice for people with learning disabilities, which have occurred in the context of the which have occurred in the context of the broader civil and human rights movements. broader civil and human rights movements. It is time to examine the services delivered It is time to examine the services delivered to people with to people with learning disabilities and learning disabilities and comorbid psychiatric disorders (mental comorbid psychiatric disorders (mental illness, personality disorders, behavioural illness, personality disorders, behavioural problems with aggression) and the evidence problems with aggression) and the evidence for their effectiveness. for their effectiveness. Psychiatric disorders are more prevalent Psychiatric disorders are more prevalent in adults with learning disabilities than in in adults with learning disabilities than in the general population (Deb the general population (Deb et al et al, 2001). , 2001). These disorders frequently go undetected These disorders frequently go undetected and thus untreated. Appropriate services and thus untreated. Appropriate services are often lacking in availability, accessibility are often lacking in availability, accessibility and adequacy. Indecision, ambiguity and and adequacy. Indecision, ambiguity and confusion concerning mental health services confusion concerning mental health services for people with learning disabilities have for people with learning disabilities have been noted (Hassiotis been noted (Hassiotis et al et al, 2000). Many , 2000). Many service planners wrongly assumed that re-service planners wrongly assumed that returning these people from residential institu-turning these people from residential institutions to community care programmes would tions to community care programmes would reduce the prevalence of psychiatric disorders reduce the prevalence of psychiatric disorders in this group. Although demands on mental in this group. Although demands on mental health services by people with learning dis-health services by people with learning disabilities have in fact increased following abilities have in fact increased following their resettlement, …