Service Delivery

Service development for intellectual disability mental health: a human rights approach.

Evans et al. (2012) · Journal of intellectual disability research : JIDR 2012
★ The Verdict

Mental health services for people with ID must be rebuilt around human-rights principles—shared resources and cross-sector training are the first steps.

✓ Read this if BCBAs who design or oversee mental-health services for teens and adults with ID
✗ Skip if RBTs looking for direct-therapy techniques only

01Research in Context

01

What this study did

Meier et al. (2012) looked at mental health services for people with intellectual disability in Australia. They read policy papers, service reports, and human-rights treaties. The team then wrote a story-style review that shows where services break human-rights rules.

The paper does not test a new therapy. Instead, it maps how current systems fail and lists fixes that put rights first.

02

What they found

The authors say most services ignore the United Nations disability treaty. People with ID get separated care that is hard to reach and rarely asks for their own goals.

They call for shared budgets, cross-training staff, and plans that the person can understand and lead.

03

How this fits with other research

Storch et al. (2012) extends the same rights idea. Their field notes from Australian adults show rights slip away in small daily chats, not just big policies. Strong friend and family circles that invite the person to every meeting guard those rights best.

Cannella et al. (2006) gives a real example. Their integrated team, mixing ID and mental-health staff, cut symptoms and risk. The review’s call for boundary-crossing reform is already working in one service.

McGeown et al. (2013) sounds like a contradiction. They warn that too much "choice" talk can exclude people with ID if no one protects them. E et al. still want choice, but both papers agree choice only works when paired with clear rights and support.

04

Why it matters

If you write plans or supervise services, treat the CRPD treaty as your job description. Add a one-page rights check to every intake: Can the client understand the plan? Did they help write it? Is a shared budget in place? This five-minute habit moves your team from fragmented care to rights-first care.

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Add a rights check box to your intake form: 'Client helped write this plan in plain language.'

02At a glance

Intervention
not applicable
Design
narrative review
Population
intellectual disability
Finding
not reported

03Original abstract

BACKGROUND: People with intellectual disability (ID) experience higher rates of major mental disorders than their non-ID peers, but in many countries have difficulty accessing appropriate mental health services. The aim of this paper is to review the current state of mental health services for people with ID using Australia as a case example, and critically appraise whether such services currently meet the standards set by the Convention on the Rights of Persons with Disabilities. METHODS: The literature regarding the current state of mental health services for people with ID was reviewed, with a particular focus on Australia. RESULTS: The review highlighted a number of issues to be addressed to meet the mental health needs of people with ID to ensure that their human rights are upheld like those of all other citizens. Many of the barriers to service provision encountered in Australia are likely also to be relevant to other nations, including the culture of division between disability and mental health services, the inadequate training of both disability and mental health workers in ID mental health, and the lack of relevant epidemiological data. None of these barriers are insurmountable. CONCLUSIONS: Recommendations are made for adopting a human rights-based approach towards the development and provision of mental health services for people with ID. These include improved policy with measurable outcomes, improved service access via clear referral pathways and the sharing of resources across disability and mental health services, and improved service delivery through training and education initiatives for both the mental health and disability workforce.

Journal of intellectual disability research : JIDR, 2012 · doi:10.1111/j.1365-2788.2012.01636.x