SERVICES
Introduction
It is now five years since Valuing People was published in
England (DH, 2001). Since then ther
e has been a str
eam of
policy, guidance and legislation affecting the lives of people with
learning disabilities who have mental health problems. These
include the Green Light Toolkit (2004), Mental Capacity Act
(2005), Disability Discrimination Act (2005) and proposed
amendments to the Mental Health Act. This paper discusses how
English policy is being implemented to meet the mental health
needs of adults with learning disabilities.
Policy context
With ‘normalisation’ and ‘ordinary life’ principles dominating the
past 30 years, large institutions closed and care shifted towards a
social agenda. Many felt that most problems that people with
learning disabilities had were as a direct result of institutionalised
lifestyles, so a mo
ve into a more socially inclusive model of
community care was what was needed. Although full of good
intentions, this belief was oversimplified. The need for mental
health services specifically for people with learning disabilities
was largely ignored; its legacy is the resultant lack of available
training and specialist services. This has undoubtedly contributed
to today’s situation where England has little in the way of local
specialist provision, and many people with learning disabilities
and complex mental health needs now reside miles from home,
detained in voluntary and private sector placements.
V
aluing P
eople is based on the principles of rights, inclusion,
choice and independence. It reinforced the need to invest in
locally-based community services and called for community
learning disability teams to deliver more training and
consultancy in order to enable mainstream services to deliver
care to people with learning disabilities while retaining smaller
caseloads of those with the most complex needs.
The Royal College of Psychiatrists (1996; 2003) recommended
the development of specialist mental health teams for people
with learning disabilities with clinicians having expertise in both
learning disability and mental health. Based locally, such
specialist mental health teams would provide community and
hospital interventions while also offering consultancy and
training to other agencies.
E
xamples of service models designed to meet these specialist
requirements include:
The Mental Health in Learning Disability Service (MHiLD) –
Bo
x 1
(Bour
as & Holt, 2001)
Virtual Mental Health (LD) Team: (Islington model) – Box 2
(Hall et al, 2006)
Managed functional needs-led teams (T
ower Hamlets
model) –
Box 3 (O’Hara, 1998).
Eddie Chaplin and Jean O’Hara
Estia Centre, London
Abstract
In the last decade we have witnessed much debate and activity around the provision of mental health services for people with learning disabilities
in England. This article looks not only at current initiatives to improve mental health care from around England, but also places them within a
policy context. Unfortunately there are areas that still fail to provide a basic care standard, some of which has been reported throughout the media
from recent investigations. Where this is the case, we outline the responses and actions that have been put in place to address these issues.
To maintain a momentum for positive change for the mental health care of people with learning disabilities, there now needs to be co-
operation between services that traditionally have not worked together for the benefit of this client group. Before an equality of mental health
service provision, in line with national standards, can be realised the traditional views and values of service providers and commissioners will
need to be challenged and tuned to the needs of this group of people.
Key words
mental health services; learning disabilities; intellectual disabilities; policy in England; current initiatives; traditional views and values
Policy implementation in England:
developments to meet the mental health
needs of people with learning disabilities
7
Advances in Mental Health and L
earning Disabilities
V
olume 1 Issue 1 Mar
ch 2007 © P
avilion Journals (Brighton) Ltd