Disconnected lives: Women with intellectual disabilities in conflict with the law

Personal and sexual boundaries: the experiences of people with intellectual disabilities

Background

Previous research shows that people with intellectual disabilities have less knowledge about sexual health and are more vulnerable to victimisation. In cases of sexual abuse, they are likely to encounter the criminal justice system as vulnerable witnesses. Several challenges arise when people with intellectual disabilities are in communication with the criminal justice system. We aimed to explore the perceptions, experiences and knowledge of people with intellectual disabilities regarding personal and sexual boundaries in order to identify factors relevant for preventing sexual abuse, to develop future studies.

Method

The study had a qualitative design. Data were collected from seven people with mild intellectual disabilities (25–40 years; 2 men, five women) through one-to-one interviews in specialised health care services for people with intellectual disabilities (SHCS). The participants lived alone, in group homes and with their families. Many received professional support services. Data were analysed using thematic analysis.

Results

The interviews identified that the participants want to be in romantic relationships and that some, consider sex to be unimportant. Many of them have had trouble finding someone to have a romantic relationship with. The participants were unsure about sexual consent related to sexual activity, though many could explain the concept of consent in other contexts. Many participants reported that they had experienced sexual abuse, including online sexual abuse. Those participants who had reported the sexual abuse had positive experiences obtaining assistance from the criminal justice system. The participants who had experienced sexual abuse reported trauma and fear related to their experiences.

Conclusion

This study highlights the need for information about sexually abusive relationships, risks online and ways to get help. More attention should be given to the impact of trauma, police and mental health treatment following sexual abuse against people with intellectual disabilities.

Barriers and requirements for parenting supports and mental health care among mothers with intellectual disabilities: Health and social service-provider perspectives

BACKGROUND

Mothers with intellectual disability (ID) experience high rates of mental illness, but these needs are not adequately addressed.

AIMS

We examined health and social service-provider perceptions of barriers to parenting and mental health care among mothers with ID and strategies for building good practice capacity.

METHODS AND PROCEDURES

In this qualitative study in Ontario, Canada, we interviewed 13 service-providers working with mothers with ID about their experiences supporting parenting and mental health in mothers with ID, including barriers to services and strategies for building good practice capacity. Data were analyzed via inductive, semantic-level thematic analysis.

OUTCOMES AND RESULTS

Perceived barriers to care provision were the vulnerable social context of women with ID, distrust of "the system" by women with ID, and siloed services. Increased training of service-providers, making accommodations in existing services, and building a community of support for women with ID were offered as strategies for good practice capacity.

CONCLUSIONS AND IMPLICATIONS

Efforts to improve mental health among mothers with ID should focus on improving service-provider capacity and accommodations in existing services, and enhancing coordination of care. WHAT THIS PAPER ADDS?: Mothers with intellectual disability (ID) experience high rates of mental illness, but supports for mothers with ID typically focus on parenting skills, and women's mental health care services do not consider the unique needs of those with ID. Health and social service-providers have reported inadequate training, fragmented services, high caseloads, and lack of practical supports as barriers to providing quality care to mothers with ID. However, no studies have examined service-providers' perceptions of needs related specifically to parenting and mental health among mothers with ID. This study provides new information on barriers to parenting and mental health care among mothers with ID and strategies for good practice capacity, from the perspectives of service-providers. Perceived barriers to care provision include social determinants of health, a distrust of "the system" by women with ID, and siloed services. Providers recommended that providing better training, including accommodations in existing services, and building a community of support could be beneficial to improving practice capacity in the context of mental health care and parenting supports. These factors need to be addressed to improve mental health among mothers with ID.

Homelessness and people with intellectual disabilities: A systematic review of the international research evidence

BACKGROUND

People with intellectual disabilities can experience homelessness, and some of the reasons differ from the general homeless population. Specific policy and practice responses are required.

METHOD

A systematic review of studies examining homelessness among people with intellectual disabilities utilizing CINAHL, MEDLINE, PsycINFO and Sociological Abstracts databases from inception to November 2019.

RESULTS

The search produced 259 papers, and following screening, a total of 13 papers were included in the review. The themes identified were (i) pathways into homelessness, (ii) experiencing homelessness and (iii) routes out of homelessness.

CONCLUSIONS

People with ID become homeless due to multifactorial issues. The identification of people within homeless services and their care and support concerns remains challenging, impacting upon the provision of assessments, interventions, care and supports. Psychosocial assessments, interventions and supports are necessary to assist people with ID to leave homelessness.