Mental health of children with learning disabilities†

The new developmental psychiatry

Psychiatric services for children and adolescents with learning disabilities have been subject to fashion and aspiration rather than pragmatic planning, at different times being claimed by different specialties. As services have atrophied, it has become clear how distinct are the clinical issues that arise in this group; issues that show developmental psychiatry at its starkest with a combination of organic, dynamic and systemic factors that require community teamwork. As services and specialties regroup, this evolving area is likely to continue defining itself, perhaps taking in adults with developmental disorders, to emerge as a new specialty, developmental psychiatry. It remains to be seen where this will sit within the health service.

Opportunities for reducing socioeconomic inequalities in the mental health of children and young people – reducing adversity and increasing resilience

Purpose

– Poor mental health and well-being disproportionately affects vulnerable and disadvantaged children and young people. The paper aims to discuss this issue.

Design/methodology/approach

– The focus of this paper is socioeconomic inequalities in perinatal, child and adolescent mental health.

Findings

– Children and young people in the poorest British households are up to three times more likely to develop mental health problems than their more advantaged peers (Green et al., 2005). The pattern can also be observed in the opposite direction, with poor mental health known to contribute to socioeconomic and other health problems (McCulloch and Goldie, 2010, Parckar, 2008). At a larger scale, the higher the level of inequality within developed countries, the higher the rate of child and adolescent mental health problems (Pickett et al., 2006).

Social implications

– Mechanisms posited as underlying such inequalities include family investment and stress processes. These factors have been taken into account when developing the economic case for investing in perinatal, child and adolescent mental health.

Originality/value

– Illustrative examples of progressive universal strategies and policies to help reduce socioeconomic inequalities in mental health, include: action to address the inequality gap in the UK; early intervention to improve mental health; investing in sustainable and evidence-based mental health services; ensuring parity of esteem, and; using appropriately designed social media and online sources to support children’s mental health.

Challenging behaviour and psychiatric disorder in intellectual disability

PURPOSE OF REVIEW

To critically review recent publications on the relationship between challenging behaviour and psychiatric disorder in people with intellectual disabilities.

RECENT FINDINGS

Although a number of recent studies have highlighted possible similarities in the aetiology of challenging behaviour and psychiatric disorder, these findings need to be viewed with caution as they do not constitute evidence that the two phenomena are equivalent. While research into their possible interrelationship has produced equivocal findings, there are a number of theoretical perspectives that have been tested to some degree by empirical studies. Intervention studies that attempt to explore these perspectives are rare, however, and there is some evidence that people with complex mental health and behavioural needs are receiving far from optimal treatment.

SUMMARY

The relationship between challenging behaviour and psychiatric disorder has yet to be adequately explored in the research literature. While both undoubtedly coexist in some people with intellectual disability, available research suggests that it is unlikely that disturbances in psychiatric functioning will underpin the majority of challenging behaviours. Evidence to link specific patterns of behaviour with particular disorders also remains elusive. Recommendations for future research are discussed.