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McCombe LH, Martin TL, Curtis H, Ediger J, Temple B. Crisis stabilisation services for people with intellectual disabilities: A systematic review. JOURNAL OF INTELLECTUAL DISABILITIES : JOID 2022; 26:1033-1056. [PMID: 34844460 DOI: 10.1177/17446295211033564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
People with intellectual and developmental disabilities sometimes engage in challenging behaviours. When behaviours escalate to the point where they pose imminent risk to the safety of people and environments, a crisis occurs that jeopardises community living and participation. In these situations, timely access to crisis stabilisation services is required. We conducted a systematic review of the literature to synthesise evidence on effective crisis stabilisation service models for challenging behaviours. A total of 46 publications met the inclusion criteria. The literature describes a spectrum of crisis stabilisation services of varying intensities including: outreach, outpatient, inpatient, respite, and capacity building through education and training. However, there is limited guidance on how to best structure service models. This review highlights the need for comprehensive and person-centred programme evaluations.
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Affiliation(s)
| | - Toby L Martin
- St.Amant Research Centre, Canada; University of Manitoba, Canada
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Ee J, Kroese BS, Lim JM, Rose J. What do specialist mental health professionals think of the mental health services for people with intellectual disabilities in Singapore? JOURNAL OF INTELLECTUAL DISABILITIES : JOID 2022; 26:972-989. [PMID: 34427139 PMCID: PMC9608008 DOI: 10.1177/17446295211030094] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 06/11/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND This research aimed to investigate the views and experiences of specialist mental health professionals working with adults with intellectual disabilities and mental health problems in Singapore in order to gain insight into the functioning of the local specialist intellectual disability mental health service and how it may be improved. METHODS Eight staff members from specialist service were interviewed. The transcriptions of the interviews were analysed using thematic analysis. RESULTS Analysis revealed four themes (1) Identifying their roles; (2) Ensuring continuity of care; (3) Disempowerment of service users and (4) Improving clinical practice. CONCLUSIONS Participants identified the challenges they faced working with this population. They highlighted the importance of building therapeutic relationships during the treatment process and discussed the stigma that people with intellectual disabilities face in the community. Recommendations and implications are discussed in relation to service provision, improving staff knowledge and recruiting more staff to work in this field.
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Affiliation(s)
- Jonathan Ee
- Jonathan Ee, School of Psychology, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK.
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Werner S, Stern I, Roth D, Tenenbaum A. Help-Seeking by Parental Caregivers of Individuals with Intellectual Disabilities and Dual Diagnosis. ADMINISTRATION AND POLICY IN MENTAL HEALTH AND MENTAL HEALTH SERVICES RESEARCH 2020; 46:321-333. [PMID: 30604003 DOI: 10.1007/s10488-018-00915-w] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
This study examined the roles of stigma and of enabling factors in help-seeking by parental caregivers of individuals with intellectual disabilities and dual diagnosis. Questionnaires were completed by 195 family caregivers. Lower family stigma was related to higher personal enabling factors (e.g. knowledge about services and previous experience in seeking help), which in turn was related to higher help-seeking behaviors. Higher professional enabling factors (e.g. attitude of the professional, services in the vicinity) were related to higher intentions to seek help, which were related to higher help-seeking behaviors. Professionals can help families achieve a greater sense of self-efficacy in their own help-seeking process by providing them with knowledge about services and facilitating a more positive experience in the process.
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Affiliation(s)
- Shirli Werner
- Center for Disability Studies, Paul Baerwald School of Social Work & Social Welfare, Hebrew University of Jerusalem, Mount Scopus, 91905, Jerusalem, Israel.
| | - Ira Stern
- Center for Disability Studies, Paul Baerwald School of Social Work & Social Welfare, Hebrew University of Jerusalem, Mount Scopus, 91905, Jerusalem, Israel
| | - Dana Roth
- Research and Evaluation Department, Beit Issie Shapiro, Ra'anana, Israel
| | - Ariel Tenenbaum
- Down syndrome and the IDD Evaluation Centers, Hadassah-Hebrew University Medical Center, Mount Scopus, Jerusalem, Israel
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Salm T. A School-Based Case Study: Developing Interprofessional Competencies to Support Students With Dual Diagnosis. JOURNAL OF POLICY AND PRACTICE IN INTELLECTUAL DISABILITIES 2017. [DOI: 10.1111/jppi.12177] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Nicholas DB, Calhoun A, McLaughlin AM, Shankar J, Kreitzer L, Uzande M. Care Experiences of Adults With a Dual Diagnosis and Their Family Caregivers. Glob Qual Nurs Res 2017; 4:2333393617721646. [PMID: 28804747 PMCID: PMC5533258 DOI: 10.1177/2333393617721646] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2017] [Revised: 06/12/2017] [Accepted: 06/15/2017] [Indexed: 11/17/2022] Open
Abstract
Individuals diagnosed with developmental disability and mental illness (a “dual diagnosis”) contend with multiple challenges and system-related barriers. Using an interpretive description approach, separate qualitative interviews were conducted with adults with a dual diagnosis (n = 7) and their caregiving parents (n = 8) to examine care-related experiences. Results indicate that individuals with a dual diagnosis and their families experience misunderstanding and stigma. Families provide informal complex care amid insufficient and uncoordinated services but are often excluded from formal care planning. A lack of available funding and services further impedes care. While negative care experiences are reported as prevalent, participants also describe instances of beneficial care. Overall, findings indicate a lack of sufficiently targeted resources, leaving families to absorb system-related care gaps. Recommendations include person- and family-centered care, navigation support, and capacity building. Prevention and emergency and crisis care services, along with housing, vocation, and other supports, are needed. Practice and research development regarding life span needs are recommended.
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Owen R, Bowers A, Heller T, Hsieh K, Gould R. The Impact of Support Services Teams: Community-Based Behavioral Health Support Interventions. JOURNAL OF POLICY AND PRACTICE IN INTELLECTUAL DISABILITIES 2016. [DOI: 10.1111/jppi.12186] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
- Randall Owen
- Department of Disability and Human Development; University of Illinois at Chicago; Chicago IL USA
| | - Anne Bowers
- Department of Disability and Human Development; University of Illinois at Chicago; Chicago IL USA
| | - Tamar Heller
- Department of Disability and Human Development; University of Illinois at Chicago; Chicago IL USA
| | - Kelly Hsieh
- Department of Disability and Human Development; University of Illinois at Chicago; Chicago IL USA
| | - Robert Gould
- Department of Disability and Human Development; University of Illinois at Chicago; Chicago IL USA
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An intensive personalised support approach to treating individuals with psychosis and co-morbid mild intellectual disability. Ir J Psychol Med 2016; 34:99-109. [PMID: 30115213 DOI: 10.1017/ipm.2016.19] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVES To evaluate the clinical benefits and associated cost effectiveness of an intensive personalised support (IPS) approach for clients suffering from psychosis and co-morbid mild intellectual disability (ID). METHOD Four individuals with a psychotic disorder and co-morbid mild ID participated in an 18-month IPS rehabilitative intervention. Biopsychosocial measures were used to evaluate clinical effectiveness. A cost analysis was undertaken to examine the cost effectiveness of the intervention. RESULTS Reductions in psychopathology including anxiety symptoms were noted in all individuals. In addition, increased functioning and quality of life were demonstrated in all cases. Overall cost reductions were noted in inpatient care, accommodation and legal/emergency expenses. CONCLUSION The IPS approach was clinically effective particularly in addressing individual's psychosocial needs, psychological functioning, daily living skills and overall quality of life. Costs had decreased for three of the four individuals, ranging from a 17% to 46% savings. The findings highlight that the intervention was cost effective in most cases at this early stage. However, further research is necessary in order to ascertain if cost savings occur over time.
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Men with disabilities – A cross sectional survey of health promotion, social inclusion and participation at community Men's Sheds. Disabil Health J 2016; 9:118-26. [DOI: 10.1016/j.dhjo.2015.08.013] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2015] [Revised: 07/08/2015] [Accepted: 08/30/2015] [Indexed: 11/19/2022]
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Pruijssers A, van Meijel B, Maaskant M, Keeman N, van Achterberg T. Quality of Diagnosis and Treatment Plans After Using the 'Diagnostic Guideline for Anxiety and Challenging Behaviours' in People with Intellectual Disabilities: A Comparative Multiple Case Study Design. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2015; 29:305-16. [PMID: 25727744 DOI: 10.1111/jar.12180] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/19/2015] [Indexed: 11/27/2022]
Abstract
BACKGROUND People with intellectual disabilities often have a multitude of concurrent problems due to the combination of cognitive impairments, psychiatric disorders (particularly anxiety) and related challenging behaviours. Diagnoses in people with intellectual disabilities are complicated. This study evaluates the quality of the diagnoses and treatment plans after using a guideline that was developed to support professionals in their diagnostic tasks. MATERIALS AND METHODS A comparative multiple case study with an experimental and control condition, applying deductive analyses of diagnoses and treatment plans. RESULTS The analyses revealed that the number of diagnostic statements and planned treatment actions in the experimental group was significantly larger and more differentiated than in the control condition. In the control group, consequential harm and protective factors were hardly mentioned in diagnoses and treatment plans. CONCLUSIONS Working with the 'Diagnostic Guideline for Anxiety and CB' leads to improved diagnoses and treatment plans compared with care as usual.
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Affiliation(s)
- Addy Pruijssers
- Esdégé-Reigersdaal, Broek op Langedijk, The Netherlands.,Inholland University, Department of Health, Sports & Welfare / Cluster Nursing, Inholland University of Applied Sciences, Amsterdam, The Netherlands
| | - Berno van Meijel
- Inholland University, Department of Health, Sports & Welfare / Cluster Nursing, Inholland University of Applied Sciences, Amsterdam, The Netherlands.,VU University Medical Center, Department of Psychiatry, EGO Institute for Health and Care Research Amsterdam, Amsterdam, The Netherlands.,Parnassia Psychiatric Institute, Parnassia Academy, The Hague, The Netherlands
| | - Marian Maaskant
- Department of Health Services Research, Maastricht University, Maastricht, The Netherlands.,Stichting Pergamijn, Echt, The Netherlands
| | | | - Theo van Achterberg
- Centre for Health Services and Nursing Research, KU Leuven, Leuven, Belgium.,Scientific Institute for Quality of Healthcare, Radboud University Medical Centre, Nijmegen, The Netherlands
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Individuals with Intellectual Disabilities: A Review of the Literature on Decision-Making since the Convention on the Rights of People with Disabilities (CRPD). Public Health Rev 2012. [DOI: 10.1007/bf03391682] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Werner S. Intention to work with individuals with dual diagnosis: testing the theory of planned behavior among students from various professions. HEALTH & SOCIAL WORK 2012; 37:81-89. [PMID: 23029975 DOI: 10.1093/hsw/hls010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Providing holistic care to individuals with the dual diagnosis (DD) of intellectual disability and mental illness is a challenging task that requires the work of various health care specialists. The aim of the current study was to examine the intentions of students from various fields to work with individuals with DD. A questionnaire was completed by 512 social work, occupational therapy, speech and language therapy, special education, and nursing students in Israel to measure students' attitudes toward working with individuals with DD, as well as their perceptions of subjective norms, controllability, and self-efficacy. Structural equation modeling showed that the students' intentions to work with individuals with DD were predicted by their attitudes and perceptions of subjective norms. Controllability was found to negatively affect their behavioral intentions. Furthermore, social work and nursing students were found to have the lowest behavioral intentions. Given the lack of education in the field of DD and the prevailing stigmatic attitudes toward this population, university programs should focus on increasing knowledge, promoting positive contact, and reducing the fear attached to working with people with DD.
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Affiliation(s)
- Shirli Werner
- Hebrew University of Jerusalem, Paul Baerwald School of Social Work and Social Welfare, Mount Scopus, Jerusalem, Israel.
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Werner S, Grayzman A. Factors influencing the intention of students to work with individuals with intellectual disabilities. RESEARCH IN DEVELOPMENTAL DISABILITIES 2011; 32:2502-2510. [PMID: 21816568 DOI: 10.1016/j.ridd.2011.07.010] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/10/2011] [Accepted: 07/11/2011] [Indexed: 05/31/2023]
Abstract
Providing adequate care to individuals with intellectual disability (ID) requires the willingness of students in various health and social professions to care for this population upon completion of their studies. The aim of the current study was to examine the factors associated with the intentions of students from various fields to work with individuals with ID, using the framework of the Theory of Planned Behavior. A structured self-administered questionnaire was completed by 512 social work, occupational therapy, speech and language therapy, special education, and nursing students. The questionnaire measured students' attitudes toward individuals with ID and toward working with this population, as well as their perceptions of subjective norms, controllability, self-efficacy, prior acquaintance with individuals with ID, and subjective knowledge about ID. Structural equation modeling showed that the students' intentions to work with individuals with ID were predicted by their attitudes and perceptions of subjective norms. Field of study and subjective knowledge were also found to be predictive of behavioral intention. The TPB proved to be a useful framework for examining students' intentions to work with persons with ID. Given the lack of education in the field of ID, as well as the prevailing stigmatic attitudes toward this population, university departments should develop programs aimed at increasing knowledge, promoting positive contact, and reducing the fear attached to working with persons with intellectual disability.
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Affiliation(s)
- Shirli Werner
- The Paul Baerwald School of Social Work and Social Welfare, Hebrew University of Jerusalem, Mount Scopus, Jerusalem 91905, Israel.
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