Increasing access      to psychological      therapies for      people with a      learning disability                    ...
Overview of presentationMonday, 14 May 2012
LD and mental health                            • MH problems and ψ distress                              more common in t...
Key Scottish policy documentsMonday, 14 May 2012
Key Scottish policy documentsMonday, 14 May 2012
Key Scottish policy documentsMonday, 14 May 2012
Key Scottish policy documentsMonday, 14 May 2012
Key Scottish policy documentsMonday, 14 May 2012
Key Scottish policy documentsMonday, 14 May 2012
Key Scottish policy documentsMonday, 14 May 2012
Key Scottish policy documentsMonday, 14 May 2012
IAPT south of the border     • £173 million invested       2007 - 2011     • IAPT primary care       services     • Low / ...
IAPT and learning disabilitiesMonday, 14 May 2012
IAPT and learning disabilities                      • Inclusion, improving                        access for minoritiesMon...
IAPT and learning disabilities                      • Inclusion, improving                        access for minorities   ...
IAPT and learning disabilities                      • Inclusion, improving                        access for minorities   ...
IAPT and learning disabilities                      • Inclusion, improving                        access for minorities   ...
Scottish policy context      Delivering for Mental Health (2006)      ‘The Matrix’ (2008)      • Adults      • Children, y...
Scottish policy context      Delivering for Mental Health (2006)      ‘The Matrix’ (2008)      • Adults      • Children, y...
Psychological therapies for                  people with LD     • The ‘unoffered       chair’         (Bender, 1993)     •...
Psychological therapies for                  people with LD     • The ‘unoffered       chair’         (Bender, 1993)     •...
Stepped care in LD services                      • Already used?                      • Feasible?                      • H...
Methodology     • 2 x 45 min focus       groups     • P’s – CLDT:       psychiatrist, 4 x       nurses, SLT, OT,       phy...
Topic guide     • Recognition/       assessment      of MH / ψ needs     • How these needs are       met     • Understandi...
Data and analysis                              • 90 mins discussion,                                >16,000 words         ...
Thematic map               Lack of         Barriers to     Varying levels              standard        recognising      of...
Conclusions     • Differing levels of MH /       ψ knowledge, training,       experience and       confidence     • Lack of...
Acknowledgements                            North East                         Edinburgh CLDT                          Kei...
Thanks for                                                       listening                  © Luc Coiffait Photography    ...
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Increasing access to psychological therapies for people with a learning disability

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Increasing access to psychological therapies for people with a learning disability

  1. 1. Increasing access to psychological therapies for people with a learning disability Fleur-Michelle Coiffait University of Edinburgh & NHS LothianMonday, 14 May 2012
  2. 2. Overview of presentationMonday, 14 May 2012
  3. 3. LD and mental health • MH problems and ψ distress more common in this group (Dosen & Day, 2001; Haddock & Jones, 2006; Brown & Marshall, 2006) • Estimated prevalence 30-50% (Smiley, 2005) • MH needs continue to be unrecognised and unmet • LD services need to follow mainstream mental health services (Hatton & Taylor, 2005)Monday, 14 May 2012
  4. 4. Key Scottish policy documentsMonday, 14 May 2012
  5. 5. Key Scottish policy documentsMonday, 14 May 2012
  6. 6. Key Scottish policy documentsMonday, 14 May 2012
  7. 7. Key Scottish policy documentsMonday, 14 May 2012
  8. 8. Key Scottish policy documentsMonday, 14 May 2012
  9. 9. Key Scottish policy documentsMonday, 14 May 2012
  10. 10. Key Scottish policy documentsMonday, 14 May 2012
  11. 11. Key Scottish policy documentsMonday, 14 May 2012
  12. 12. IAPT south of the border • £173 million invested 2007 - 2011 • IAPT primary care services • Low / high intensity therapists • Work at defined stepsMonday, 14 May 2012
  13. 13. IAPT and learning disabilitiesMonday, 14 May 2012
  14. 14. IAPT and learning disabilities • Inclusion, improving access for minoritiesMonday, 14 May 2012
  15. 15. IAPT and learning disabilities • Inclusion, improving access for minorities • Service commissioning for whole communityMonday, 14 May 2012
  16. 16. IAPT and learning disabilities • Inclusion, improving access for minorities • Service commissioning for whole community • Overcoming health inequality in NHS servicesMonday, 14 May 2012
  17. 17. IAPT and learning disabilities • Inclusion, improving access for minorities • Service commissioning for whole community • Overcoming health inequality in NHS services …the reality?Monday, 14 May 2012
  18. 18. Scottish policy context Delivering for Mental Health (2006) ‘The Matrix’ (2008) • Adults • Children, young people, families • Long-term conditions • Physical healthMonday, 14 May 2012
  19. 19. Scottish policy context Delivering for Mental Health (2006) ‘The Matrix’ (2008) • Adults • Children, young people, families • Long-term conditions • Physical health …where is LD?Monday, 14 May 2012
  20. 20. Psychological therapies for people with LD • The ‘unoffered chair’ (Bender, 1993) • Growing evidence base for CBT (Beail, 2003) • Multidisciplinary biopsychosocial formulation (Ingham et al., 2008) • Behavioural family therapyMonday, 14 May 2012
  21. 21. Psychological therapies for people with LD • The ‘unoffered chair’ (Bender, 1993) • Growing evidence base for CBT (Beail, 2003) • Multidisciplinary biopsychosocial formulation (Ingham et al., 2008) • Behavioural family therapy …why not?Monday, 14 May 2012
  22. 22. Stepped care in LD services • Already used? • Feasible? • How would it work? • How would it look? • Skills gaps? • Training / supervision needs? • Alternatives?Monday, 14 May 2012
  23. 23. Methodology • 2 x 45 min focus groups • P’s – CLDT: psychiatrist, 4 x nurses, SLT, OT, physio, team secretary • Audio recorded and transcribed verbatim • Process notes • Stimulus material and topic guideMonday, 14 May 2012
  24. 24. Topic guide • Recognition/ assessment of MH / ψ needs • How these needs are met • Understanding / use of ψ approaches • Supervision, training • Stepped careMonday, 14 May 2012
  25. 25. Data and analysis • 90 mins discussion, >16,000 words • Transcribed in full • NVivo 8 used for coding and organising thoughts • Thematic analysisMonday, 14 May 2012
  26. 26. Thematic map Lack of Barriers to Varying levels standard recognising of knowledge Lack of assessment mental health and training standardised protocol / tool needs procedure / Lack of tool structured, Barriers to Time evidence- meeting constraints based mental health approaches needs Supervision Not enough Firefighting issues people to do itMonday, 14 May 2012
  27. 27. Conclusions • Differing levels of MH / ψ knowledge, training, experience and confidence • Lack of standardised assessment tools/ protocols • Limited evidence base → limited training/ guidelines/ policy availableMonday, 14 May 2012
  28. 28. Acknowledgements North East Edinburgh CLDT Keith Marshall, CBT Therapist in LDMonday, 14 May 2012
  29. 29. Thanks for listening © Luc Coiffait Photography kindly provided by www.luccoiffait.comMonday, 14 May 2012
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