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Interventions and services for people with severe mental health needs
Edited by Dr. Colin Hemmings
Introduction
Adults with intellectual disabilities are often unsure how to access urgent mental health care. This widespread impression from clinical practice has been supported by evidence from carers that their knowledge of how to access mental health crisis care is often not clear and that the experience of this urgent care for service uses and cares is often unsatisfactory ([3] Hemmings et al. , 2009b). Further research, on the opinions of a large number of specialist clinical staff, highlighted the need for the provision of information should the service user relapse. A Delphi survey found that the service components of crisis plans, out-of-hours support and provide a comprehensive list of contacts should service user relapse were all considered essential by consensus opinion of clinicians ([2] Hemmings et al. , 2009a).
Mental health crises in people with intellectual disabilities are often responded to by staff (for example clinicians in generic emergency services) that do not have specific experience or training in working with this population group. [7] Lunsky et al. (2008), [6] Lunsky and Gracey (2009) and [10] Weiss et al. (2009) have described problems of emergency psychiatric services for people with intellectual disabilities, from the various perspectives of service users, carers and the hospital staff. It is widely recognized that people with intellectual disabilities tend to have increased difficulties in communicating their experiences and distress. These differences are likely to be even more pronounced when they are in a crisis. Provision of key information about the service user would therefore potentially be of great benefit for the person, their carer, emergency workers, clinicians and other staff that may help them. Knowledge of basic information about services and contacts might also improve the ability of service users to seek urgent help. Increased awareness of how to access help in a crisis would be likely to help reduce distress for both service users and carers.
In generic mental health services there has been research into the provision of crisis information by use of mental health crisis cards and joint crisis plans ([9] Sutherby et al. , 1999; [5] Henderson et al. , 2004). Their use has been associated with a reduction...