Learning Disability and Mental Health

Introduction

It is common to hear of educators as well as parents relating on how they overcome challenges with children who appear exceptionally bright but for some unclear reason seem to be struggling academically (JCPMH, 2013). Numerous parents as well as educators have been proactively looking for ways to ensure that such children develop and learn and are subsequently successfully integrated into society (Atkinson, Boulter, Hebron, Moulster, Giraud-Saunders & Turner, 2013). One of the greatest challenges that individuals diagnosed with learning disabilities have is a high probability of succumbing to mental health illnesses (Thornicroft & Tansella, 2013; Dodd, Joyce, Nixon, Jennison & Heneage, 2011). Mental health illnesses tend to adversely impact on how an individual behaves, feels, or thinks. Literature on this subject indicates that mental health related problems tend to occur for no apparent reason and may last for durations of few days to an entire lifetime (JCPMH, 2013; Atkinson et al., 2013). It is common to hear of discrimination, prejudice and stigma experiences affecting persons with mental health problems and/or learning disabilities.

Learning disabilities stems from lifelong conditions which normally start prior to an individual attaining adulthood (Roy & Bhaumik, 2012). Some of these conditions are developmental factors, genetic factors, or brain trauma at birth (Dodd et al., 2011). This results into instances where the individual’s degree of intellectual functioning becomes compromised and as such, the effects remain permanently as well as affecting physical development (Handley, Southwell & Steel, 2012; JCPMH, 2013). On the other hand, mental health problems tend to affect anyone among the general populations but can be managed through appropriate treatment interventions (Lindblad, Gillberg & Fernell, 2011). According to the available literature material on mental health and learning disabilities, nearly 40% of the global populations with learning disabilities suffer from mental illness (Emerson, Hatton, Robertson, Roberts, Baines & Glover, 2012). On the same note, the same statistic applies for children. This research paper seeks to look into instances where persons with a learning disability tend to have the issue of mental illness overlooked.

Statement of the Problem

Previous as well as current epidemiological studies designed to rationalize the factors and prevalence rates concerning mental health problems affecting adults known to have learning disabilities provide contradictory conclusions (Thornicroft & Tansella, 2013). As such, this project seeks to employ enhanced methodological approaches to attempt to eliminate challenges associated to the state of participants chosen for research (Emerson et al., 2012). More so, this project will address the issues concerning the fact that caregivers may often fail to attribute clinical manifestations to mental health (Leyin, 2011). As a result, it is common to find that individuals manifesting both learning disabilities as well as mental health problems receive inadequate healthcare and support.

Hypothesis

This project seeks to seek intervention strategies to reach out to adult populations with learning disabilities and mental health challenges with respect to help seeking behaviors. The second hypothesis will be concerned with addressing the problems and barriers people with mental health challenges and learning disabilities experience while attempting to access comprehensive health services. The third hypothesis will revolve about ascertaining effective and practical intervention aimed at enhancing gainful healthcare services.

Methodology

For this particular project, a steering group of medical professionals involving clinicians, academicians and service users was formed with the sole aim of designing a qualitative research endeavor to achieve set goals (JCPMH, 2013). An aspect deemed as overly important was to ensure that ethical considerations were duly addressed throughout the research process. Approval from my academic institution’s ethical committee was deemed as mandatory regarding participant confidentiality and informed consent (Dodd et al., 2011). As such, participants were given the express authority to ask for consent withdrawal. It is important to point out that the participants chosen had capacity to knowingly consent to the research. The research emphasized on the different personal experiences of participants relative to living with learning disabilities and problems concerning their mental health (Dodd et al., 2011).

The qualitative research employed was in essence a survey that sought to use a structured questionnaire with questions designed to offer accurate measurements of opinions, behaviors and experiences of participants (JCPMH, 2013). Appropriate random sampling and targeted response rates were appraised in ensuring questions ideally aligned to the research study’s objectives.

Focus Groups

The research project employed to varying qualitative research methodologies via two focus groups, an individual interview and digital recording of personal experiences (JCPMH, 2013). The first focus group consisted of same sex participants while the second group was made up of individuals from both genders. The same sex focus group was aimed at enabling female participants free offer experiences on living with learning disabilities and problems with their mental health (Handley, Southwell & Steel, 2012). This is in essence due to the fact that most had reported of suffering from sexual abuses from the opposite gender. The mixed gender focus group sought to gain experiences from the participants in a contemporary social setting.

Each group consisted of 5 participants such the combined mixed gender group had a total of 10 participants. It is critical to point out that all of the participants were individuals in support groups for people with learning disabilities and mental health problems. A limit on group discussion was set at 45 minutes under the supervision of a co-facilitator. All discussions were recorded on digital devices and later transcribed verbatim.

Questions for the Focus Groups What are the traits of a good worker? How do you feel when you encounter a worker who is not so good? Do you think it is important to have staff with professional training? If you began feeling bad, upset or low; who do you think can be of assistance to you?

Individual Interviews

These were conducted to get the views from a wide array of medical staff with experiences in directly working with individuals harboring learning disabilities as well as mental health issues (Handley, Southwell & Steel, 2012). These included community health professionals and institution based medical practitioners working with individuals with learning disabilities and mental health issues. The interviews were also recorded and afterwards converted to verbatim

This particular sample size was sourced from both rural and urban settings and involved participants in voluntary, private or statutory service (Emerson et al., 2012). The ten participants included 2 team leaders, a senior support staff and the remainder included 7 support workers. All were qualified healthcare providers with four support staff having in-house training qualification of mental health issues known to affect individuals with learning disabilities. These mental health issues included bipolar disorder, mental health, challenging behavior and autism (Lindblad, Gillberg & Fernell, 2011). All were aged between 25 and 50 years. Eight were female while only two were male.

Prior to the commencement of the questionnaire guided interviews, all participants were subject to a session where they listened in on the experiences of the other group of participant recorded earlier. A video session was then availed to serve as a remainder to the staff of the impact that mental health problems present to adults known to be harbor learning disabilities.

Interview Questions What are the traits of an ideal mental health worker? What roles do you as a health worker play in your workplace that service users consider as helpful? What makes the services offered by some workers wanting? What do you envisage as good training an experience for mental health worker? What information should be availed to staff prior to commencing work? What assistance can be availed to workers to improve service delivery to clients? What strategies should supervisors or managers invoke to improve the service delivery outcomes of support staff? Is formal training necessary towards ensuring desired service delivery to clients? If a client with learning disabilities and mental health issues is unwell, what services would you call for in an effort to alleviate their problems?

Data Analysis

The information collected via the questionnaire guided interviews employed the Interpretive Phenomenological Analysis method (Lindblad, Gillberg & Fernell, 2011). This method was deemed ideal for this particular project as it seeks at offering an understanding of experiences of persons under investigation as well as the meanings attached to such experiences. It is a method that places much emphasis on the subjective experiences of individuals via an analysis as well as interpretive process by a researcher (Lindblad, Gillberg & Fernell, 2011). As such each individual case is critically analyzed in an effort to draw up core themes. Similarly, it is a method that enables the researcher to adequately grasp emerging themes exhibit in individual cases and can be shared across other cases. It is important to point out that content of the arising themes was carefully founded on original data (Lindblad, Gillberg & Fernell, 2011).

Findings

In an effort to realize the objective of the project, findings from the individual interviews and from the focus groups were compared. Some general themes emerged as well as some of which were identified as unique or in other terms less commonly observed aspects. However, only two of these will be presented below and will involve direct quotes aimed at clarifying emerging themes.

Desirable Mental Health Staff Qualities      

Qualities which the respondents considered as desirable when relating serving clients with learning disabilities and mental health issues involved: good communication skills; openness and honesty coupled with sensitive and gentle care; genuine interest working with the said clientele while forming professionally informed trust relationships; providing care services that promote competence; and acknowledging and understanding the fact that past experiences ought to positively impact on the success of present mental health interventions (Roy & Bhaumik, 2012).

For instance, the focus groups pointed out they appreciated staff “who genuinely agreed to keep us company when the need arises.” As such, staffs who offered genuine care to patients were deemed as a vital component towards ensuring their wellbeing and more so, enabled them gain greater self-respect and self-esteem. On the other hand, staff working with patients harboring learning disabilities and mental health issues pointed out that it was indeed a challenge to offer the above states level of care due to other commitments they played in residential institutions. For instance, one of the staff pointed out that, “Yes, I would really like to be the particular staff member that patients may look up to for care and as such, this often enables patients open up about their real problems. But I am also obligated to perform other roles in the institution like administrative duties.”

Relevant and Ongoing Supervision and Staff Training

The individuals with learning disabilities and mental health issues valued the notion of mental health staff being professionally qualified (Roy & Bhaumik, 2012). One participant in the focus group pointed out that, “I would not imagine a situation where an unqualified mental health staff member could be assigned of availing me with the desired mental health care. I believe that all staff ought to have professional certification as no lay man can possibly have an idea of what such a role entails.” The same applied for the participants working as mental health staff. As such the emerging theme was that ongoing and relevant staff training was critical not only for them but also for other staff at all levels in healthcare institutions towards improving service delivery. One of the respondents remarked that, “In situations where an individual with a mental health issue is housed at a care home, he or she is entirely reliant on the staff there and if such staff fails to deliver adequate services, there is the need for such staff to be offered more education and professional training.

Conclusion and Recommendations

An abundance of constructive and innovative recommendations were expressed by the people living with learning disabilities and metal health issues as well all the participating mental health practitioners. The fact that staff with genuine care for their roles in assisting individuals with mental health problems as well as learning indicated that staff selection should be considered much during recruitment exercises. This aspect was strongly supported by the emergent them regarding desirable mental health practitioner qualities. Towards ensuring that the service users are guaranteed quality mental healthcare interventions, good liaison and regular reviews among professionals was perceived as a significant determinant of the degree of service quality availed to service users.

 

 

References

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Emerson, E. & Einfeld, S. L. (2011). Challenging behavior. Cambridge, UK: Cambridge University Press.

Emerson, E., Hatton, C., Robertson, J., Roberts, H., Baines, S. & Glover, G. (2012). People with Learning Disabilities in England 2011. Improving Health and Lives: Learning Disability Observatory.

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