Learning Disability Today
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NICE is consulting on a new quality standard in this area that will apply to work across health and social care. The standard was created through an earlier engagement exercise, and the formal consultation period is very short, so it seems unlikely there will be substantial changes in its requirements. Our briefing summarises its main content.
This quality standard covers the prevention, assessment and management of mental health problems in people with learning disabilities in health, social care, educational, forensic and criminal justice settings.
NICE say the standard is also intended to cover family members, carers and care workers. I don’t know why care workers are not simply seen as important members of the settings listed….and I don’t quite understand how carers and family members can be ‘covered’ by NICE standards.
Problem behaviours are not addressed in the quality standard. They are covered by the NICE quality standard on challenging behaviour and learning disabilities.
The new quality standard is seen to be needed because of the benefits that will arise from earlier identification of dual problems – an identification that is sometimes difficult because people’s learning disabilities may cloak underlying mental health problems.
The standard is also important because of what is known about the higher rate of mental health problems amongst people with a learning disability. The background paper for the standard says these include schizophrenia, bipolar disorder, dementia, and ADHD. Autism is also considerably more common in people with learning disabilities.
Quoted prevalence rates of mental health problems for children and young people with learning disabilities have been reported to be higher than for other children and young people for 27 out of 28 specified diagnostic categories, and statistically significantly so for 20 of these 28 comparisons.
The standard notes that the physical health state of people with learning disabilities can contribute to mental ill health, as can the degree and cause of their learning disabilities, biological factors, psychological factors such as trauma, and social factors such as neglect, poverty and lack of social networks.
Estimates in the standard suggest that, in the UK population, 28% (excluding those with problem behaviour) of adults with learning disabilities experience mental health problems at any point in time. An estimated 24% (again excluding problem behaviours) of children and young people with learning disabilities experience mental health problems at any point in time. These rates are much higher than for people who do not have learning disabilities.
The quality standard is expected to contribute to improvements in the following outcomes:
The standard provides tables showing how it is intended to contribute to the achievement of outcomes in the:
Before going on to set out its specific requirements, the standard makes a number of overarching points. Expectations are that:
The quality statements are that: