Psychiatric service use and psychiatric disorders in adults with intellectual disability.
Nearly half of adults with ID already use specialist psychiatry, so BCBAs must build joint care routines around behaviour and ASD diagnoses.
01Research in Context
What this study did
The team counted how many adults with intellectual disability (ID) used specialist psychiatric clinics in one UK health region. They also listed the mental-health diagnoses doctors gave these clients.
Data came from clinic records, not new tests or treatments. The sample was the adults already known to ID services.
What they found
Forty-six percent of the adults had visited specialist psychiatric services. The top two labels written in the files were "behaviour disorder" and "autism spectrum disorder."
Less common were mood, anxiety, and psychotic conditions. In short, behaviour and ASD drove most referrals.
How this fits with other research
Tsakanikos et al. (2010) looked at the same region two years later and found minority clients entered care younger and with more schizophrenia labels. The 2008 snapshot missed this ethnicity angle, so combine both papers to see the full referral picture.
Fournier et al. (2004) showed specialist inpatient units beat generic ones for adults with ID. Bhaumik et al. (2008) now show almost half of community clients already touch psychiatry, underlining why good inpatient–outpatient hand-offs matter.
Dai et al. (2023) surveyed US outpatient doctors and found most speak only to caregivers, not patients. Their 2023 data extend the UK 2008 finding: high service use continues, but real teamwork still lags.
Why it matters
If you serve adults with ID, expect every second client to also see psychiatry. Map your behaviour plan to their psychiatric diagnosis and meds. Ask for the psychiatrist’s report and offer yours—shared care stops conflicting advice and cuts crisis calls.
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02At a glance
03Original abstract
BACKGROUND: UK policies aim to facilitate access to general psychiatric services for adults with intellectual disability (ID). If this is to be achieved, it is important to have a clear idea of the characteristics and proportion of people with ID who currently access specialist psychiatric services and the nature and extent of psychiatric disorders in this population. METHODS: A cross-sectional study was carried out on all adults with ID using specialist services in Leicestershire and Rutland, UK, between 2001 and 2006. Characteristics of individuals seen by psychiatric services and the nature and prevalence of psychiatric disorders were investigated. RESULTS: Of 2711 adults identified, 1244 (45.9%) accessed specialist psychiatric services at least once during the study period. Individuals attending psychiatric services were more likely to be older and to live in residential settings; they were less likely to be south Asian or to have mild/moderate ID. The prevalence of psychiatric disorders among the total study population was 33.8%; the most common disorders were behaviour disorder (19.8%) and autistic spectrum disorders (8.8%). Epilepsy was highly prevalent (60.8%) among those attending psychiatric services without a mental health diagnosis. Behaviour disorders and autistic spectrum disorders were more common in men and in adults with severe/profound ID, whereas schizophrenia and organic disorders were more common in women and in adults with mild/moderate ID. Depression was also more common in women with ID. CONCLUSIONS: Psychiatric disorders and specialist health problems are common among adults with ID and the profile of psychiatric disorders differs from that found in general psychiatry. Close collaboration between general and specialist service providers is needed if the current move towards use of general psychiatric services in this population is to be achieved. The measures should include a clear care pathway for people with ID and mental health problems to facilitate the smooth transfer of patients between specialist and generic mental health services and arrangements for joint working where input from both services is required. The commissioning framework for such processes should be in place with appropriate pooling of resources.
Journal of intellectual disability research : JIDR, 2008 · doi:10.1111/j.1365-2788.2008.01124.x