Intellectual Disability Psychiatry: A Practical Handbook PDF
Preview Intellectual Disability Psychiatry: A Practical Handbook
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 A John Wiley & Sons, Ltd., Publication Copyright©2009 JohnWiley&SonsLtd,TheAtrium,SouthernGate,Chichester,WestSussex PO198SQ,England Telephone(+44)1243779777 Email(forordersandcustomerserviceenquiries):[email protected] VisitourHomePageonwww.wileyeurope.comorwww.wiley.com AllRightsReserved.Nopartofthispublicationmaybereproduced,storedinaretrievalsystemortransmittedinany formorbyanymeans,electronic,mechanical,photocopying,recording,scanningorotherwise,exceptunderthe termsoftheCopyright,DesignsandPatentsAct1988orunderthetermsofalicenceissuedbytheCopyright LicensingAgencyLtd,90TottenhamCourtRoad,LondonW1T4LP,UK,withoutthepermissioninwritingofthe Publisher.RequeststothePublishershouldbeaddressedtothePermissionsDepartment,JohnWiley&SonsLtd, TheAtrium,SouthernGate,Chichester,WestSussexPO198SQ,England,[email protected],or faxedto(+44)1243770620. 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OtherWileyEditorialOffices JohnWiley&SonsInc.,111RiverStreet,Hoboken,NJ07030,USA Jossey-Bass,989MarketStreet,SanFrancisco,CA94103-1741,USA Wiley-VCHVerlagGmbH,Boschstr.12,D-69469Weinheim,Germany JohnWiley&SonsAustraliaLtd,33ParkRoad,Milton,Queensland4064,Australia JohnWiley&Sons(Asia)PteLtd,2ClementiLoop#02-01,JinXingDistripark,Singapore129809 JohnWiley&SonsCanadaLtd,6045FreemontBlvd,Mississauga,Ontario,L5R4J3,Canada Wileyalsopublishesitsbooksinavarietyofelectronicformats.Somecontentthatappearsinprintmaynotbe availableinelectronicbooks. 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
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