Intellectual Disability Psychiatry: A Practical Handbook

280 Pages·2009·2.295 MB·English

Intellectual Disability Psychiatry
Intellectual Disability Psychiatry: A practical handbook Edited by Angela Hassiotis, Diana Andrea Barron and Ian Hall
© 2009 John Wiley & Sons Ltd. ISBN: 978-0-470-74251-8
Intellectual Disability Psychiatry
A practical handbook
Editors
Angela Hassiotis
Senior Lecturer
Department of Mental Health Sciences
University College London
UK
Diana Andrea Barron
Clinical Research Fellow
Department of Mental Health Sciences
University College London
UK
Ian Hall
Consultant Psychiatrist
East London NHS Foundation Trust
UK
EndorsedbytheInternationalAssociationfor
theScientificStudyofIntellectualDisabilities
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LibraryofCongressCataloguing-in-PublicationData
Intellectualdisabilitypsychiatry:apracticalhandbook/editors,AngelaHassiotis,DianaAndreaBarron,IanHall.
p.;cm.
Includesbibliographicalreferencesandindex.
ISBN978-0-470-74251-8(alk.paper)
1. Peoplewithmentaldisabilities–Mentalhealth. I.Hassiotis,Angela.II.Barron,DianaAndrea.III.Hall,IanP.
[DNLM:1. MentalDisorders–psychology.2. MentalHealthServices.3. MentallyDisabled
Persons–psychology. WM140I6062009]
RC570.2.I652009
616.89–dc22
2009024882
BritishLibraryCataloguinginPublicationData
AcataloguerecordforthisbookisavailablefromtheBritishLibrary
ISBN9780470742518
Typesetin10.5/13ptBembobyLaserwordsPrivateLimited,Chennai,India
PrintedandboundinSingaporebyMarkonoPrintMediaPteLtd
Thisbookisprintedonacid-freepaper
CoverIllustrationbyManzurSobhan
Contents
List of Contributors vii
Foreword xi
TonyHolland
1 Introduction 1
AngelaHassiotis,DianaAndreaBarronandIanHall
2 Effective Communication 3
DianaAndreaBarronandEmmaWinn
3 Clinical Assessment 21
NeillSimpson
4 Assessing Mental Capacity and Making Best Interest Decisions 37
IanHallandAfiaAli
5 Common Mental Disorders (Depression, Anxiety, OCD, PTSD) 51
ElspethBradley,RebeccaGoody,ShirleyMcMillanandAndrewLevitas
6 Psychotic Illness 67
AngelaHassiotisandAmandaSinai
7 Mental Health Aspects of Autism Spectrum Disorders 85
PeterCarpenter
8 Substance Misuse 101
HelenMillerandEmmaWhicher
9 Challenging Behaviour 115
DavidSmithandWilliamHowie
vi CONTENTS
10 Interaction between Mental and Physical Health 133
MichaelKerrandBasilCardoza
11 Mental Health of Older People 149
AndreStrydomandJenniferTorr
12 Management of Offenders with Intellectual Disabilities 169
EvanYacoubandIanHall
13 Mental Health Crises 185
DeirdreO’Brady
14 Pharmacological Interventions 203
ShoumitroDeb
15 Psychological Interventions 223
KatrinaScior
16 Community Care 237
PhilipDoddandPatriciaNoonanWalsh
Appendix A Critique of the ICD 10 and DSM IV based
Classification of Mental Disorders in Intellectual
Disability 253
AnnaCooperandAngelaHassiotis
Appendix B A to Z of Disciplines That May Contribute to the
Multi- and Interdisciplinary Work as Applied
to Mood and Anxiety Disorders 257
ElspethBradley,RebeccaGoodyandShirleyMcMillan
Index 265
List of Contributors
Afia Ali Anna Cooper
EastLondonNHSFoundationTrust DivisionofCommunityBasedSciences
LondonE14DG UniversityofGlasgow
UK PsychologicalMedicineAcademic
Centre
Diana Andrea Barron GartnavelRoyalHospital
UCLDepartmentofMentalHealth 1055GreatWesternroad
Sciences GlasgowG120XH
LondonW1W7EJ UK
UK
Shoumitro Deb
Elspeth Bradley DepartmentofPsychiatry
SurreyPlaceCentre UniversityofBirmingham
DepartmentofPsychiatry Edgbaston
TorontoONM5T1R8 BirminghamB152TT
Canada UK
Basil Cardoza Philip Dodd
ABMUniversityNHSTrust StMichael’sHouse
LearningDisabilityDirectorate Ballymun
CardiffCF55WF Dublin9
UK Ireland
Peter Carpenter Rebecca Goody
KingswoodCLDT CornwallPartnershipNHSTrust
BristolBS158PQ BodminPL311AQ
UK UK
viii LISTOFCONTRIBUTORS
Ian Hall Deirdre O’Brady
EastLondonNHSFoundationTrust EastLondonNHSFoundationTrust
LondonE14DG LondonE14DG
UK UK
Angela Hassiotis Katrina Scior
UCLDepartmentofMentalHealth ResearchDepartmentofClinical,
Sciences EducationalandHealthPsychology
LondonW1W7EJ LondonWC1E6BT
UK UK
William Howie Neill Simpson
AssessmentandInterventionTeam EastDunbartonshireJLDT
SouthWestLondonandStGeorge’s KirkintillochG661XQ
MentalHealthNHSTrust UK
London
UK Amanda Sinai
CamdenLearningDisabilitiesService
Michael Kerr LondonNW17JR
WelshCentreforLearningDisabilities UK
CardiffCF143BG
UK David Smith
CAMHS
Andrew Levitas SouthWestLondonandStGeorge’s
DepartmentofPsychiatry MentalHealthNHSTrust
UniversityofMedicine andDentistry London
NewJerseyUMDNJ/SOM UK
StratfordNJ08084
USA Andre Strydom
DepartmentofMentalHealth
Shirley McMillan Sciences
SurreyPlaceCentre HampsteadCampus
Toronto,OntarioM5S2C2 LondonNW32PF
Canada UK
Helen Miller Jennifer Torr
AdultTeamNationalDeafServices CentreforDevelopmentalHealth
SouthWestLondonandStGeorge’s Victoria
MentalHealthServicesNHSTrust MonashUniversity
LondonSW129HW NottingHill
UK Australia
LISTOFCONTRIBUTORS ix
Petricia Noonan Walsh Emma Winn
CentreforDisabilityStudies CamdenLearningDisabilitiesService
UniversityCollegeDublin LondonNW17JR
Belfield,Dublin4 UK
Ireland
Evan Yacoub
Emma Whicher EastLondonNHSFoundationTrust
AdultTeamNationalDeafServices LondonE14DG
SouthWestLondonandStGeorge’s UK
MentalHealthServices NHSTrust
LondonSW129HW
UK
Foreword
Peoplewithintellectualdisabilitiesareamongthemostcomplexandmostrewarding
of people to work with and the changes in attitudes, in services and in working
practices that have occurred in this field in the UK and in some other parts of the
worldhavebeentrulyremarkable.Centraltosuchchangeshasbeentherecognition
of the importance of respect for the human rights of people with intellectual
disabilities, as exemplified by the recent UN Convention on the Rights of Persons
with Disabilities, together with an understanding that people with intellectual
disabilities vary considerably in the nature and extent of their needs and in their
strengths and vulnerabilities. The skills necessary to meet such needs are diverse
and require collaborative work across disciplines and between staff from different
agencies,includingeducation,health,socialservicesanddifferent serviceproviders.
Achieving much of what people with intellectual disabilities, their families,
support workers and others working with people with intellectual disabilities might
aspire to, in terms of social inclusion, choice and participation, will depend not just
on the opportunities available to people with intellectual disabilities. Also central is
ensuring, as far as is possible, sound physical and mental health, and the provision
of support and communication strategies that are based on an understanding of
individual need. This approach requires a clear understanding of the responsibilities
of all those concerned with respect to the prevention, detection and treatment of
ill health and ready access to primary and secondary health services and to specialist
services as and when required. The extent of health inequalities and the attitudinal
and practical barriers to primary, secondary and specialist health care services are
increasinglyacknowledged,ifnot,asyet,exactlyresolved.
This book is a very welcome contribution to the literature with its specific
focus on the mental health of people with intellectual disabilities. As exemplified
by the different chapters, this has been an area of substantial development over the
last few years. Clinicians and researchers have gained a much better recognition
of the relevance of different conceptual models of understanding of the various
developmental, biological, psychological and social factors that might predispose
xii FOREWORD
to, precipitate and/or maintain the occurrence of particular behaviours and/or
abnormalmentalstatesaffectingpeoplewithintellectualdisabilities,andoftherange
of interventions that should be considered. The focus for the early chapters is on
assessment and on the complex issues that can arise with respect to consent and
the capacity of individuals to consent to interventions. The subsequent chapters
address various aspects of psychiatric comorbidity and focus on specific issues that
are becoming increasingly relevant, particularly with respect to people with mild
intellectual disabilities, such as substance misuse and the needs of those arrested,
charged with and/or convicted of offences. Other chapters focus on challenging
behaviour and also on the mental health needs of older people with intellectual
disabilities–perhaps best exemplified by the age-related needs of people with
Down’ssyndrome.Thefinalchaptersareoninterventionsandonservices.
This book brings together under one cover present-day knowledge and through
itsverypublicationmakesaclearstatementabouttheimportanceoftheseissuesand
of what can be done. This book is fundamentally optimistic in that its emphasis is
on the benefits of sound assessment and informed intervention, yet it also brings to
ourattentionthelimitationsofourknowledgeandthecomplexity ofthefield.
Tony Holland
April 2009