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Mind, State and Society examines the reforms in psychiatry and mental health services in Britain during 1960-2010, when de-institutionalisation and community care coincided with the increasing dominance of ideologies of social liberalism, identity politics and neoliberal economics. Featuring contributions from leading academics, policymakers, mental health clinicians, service users and carers, it offers a rich and integrated picture of mental health, covering experiences from children to older people; employment to homelessness; women to LGBTQ+; refugees to black and minority ethnic groups; and faith communities and the military. It asks important questions such as: what happened to peoples' mental health? What was it like to receive mental health services? And how was it to work in or lead clinical care? Seeking answers to questions within the broader social-political context, this book considers the implications for modern society and future policy. This title is also available as Open Access on Cambridge Core.

"Historical Perspectives on Mental Health and Psychiatry Introduction In the period from the 1960s to the 2010s, there are six major shifts in encounters between professionals and their patients. They are: deinstitutionalization, antipsychiatry, patients' movements, changes in diagnostic nomenclature, evidence-based medicine, and the privileging of psychopharmacology, neurochemistry, and neurobiology. These themes overlap to varying degrees. Linked to these changes are major shifts in the care of older people with mental health issues, the 'treatment' of homosexuals, debates about informed consent, the 'medicalisation' of everyday complains, and shifts from psychosocial models of psychiatry to biomedical ones"--

Fully revised, this new edition reviews the most up-to-date and clinically relevant information on the mental health and behavioral problems of people with intellectual, developmental and learning disabilities, also previously known as mental retardation. Providing the latest evidence base from the literature and embracing clinical experience, it covers the essential facts and concepts relating to coexisting medical and psychiatric disorders, with new and updated chapters on mental health and epilepsy, schizophrenia spectrum disorders, personality disorders, and mental health problems in people with autism and related disorders. The disorder-based chapters are complemented by chapters on carer and family perspectives, possible future developments and contributions highlighting the principles of assessment, management and services from global and historical perspectives. This is essential hands-on practical advice for psychiatrists, psychologists and all other mental health professionals including nurses, therapists, social workers, managers, service providers and commissioners

The specialist mental health model and other services in a changing environment / Eddie Chaplin, Dimitrios Paschos & Jean O'Hara -- Services for people with intellectual disability and offending behaviour / Eddie Chaplin & Kiriakos Xenitidis -- An international perspective of mental health services for people with intellectual disability / Nancy Cain. [et al.] -- Assessment, diagnosis, and rating instruments / Andrew Flynn and Shaun Gravestock -- Service use and outcomes / Colin Hemmings -- Neuroimaging and genetic syndromes / Duncan Harding and Dene Robertson -- The association between psychopathology and intellectual disability / Max Pickard and Titi Akinsola -- Training professionals, family carers, and support staff to work effectively with people with intellectual disability and mental health problems / Helen Costello. [et al.].

Mental health services for people with mental retardation have been receiving greater attention over recent years following a long period of inactivity. The main policy factors which influenced the developments of services were in the USA, the emphasis on deinstitutionalisation and normalisation, and in the UK the focus on social care. Progress in the assessment of psychiatric disorders and improved diagnostic techniques have stimulated the development of a wide range of mental health services for people with mental retardation, compatible with current ideology of community care on both sides of the Atlantic. Specialist multi disciplinary, community based and easily accessible mental health services should be available for people with mental retardation. Economic cost, quality of care, and training of professionals and direct care staff, remain some of the challenges faced by purchasers and providers of mental retardation and mental health services in both countries.

A practical and comprehensive introduction for carers to mental health problems, this accessible guide outlines a range of signs and symptoms of mental health problems that can affect people with intellectual disabilities. The guide explains why mental health problems develop, and advises on what can be done to help people with intellectual disabilities and carers themselves. With chapters on specific disabilities such as autism and epilepsy, the authors cover topics such as: treatment and interventions for mental health problems; getting the best services and understanding policy around menta

Background  Care staff play a key role in identifying individuals with intellectual disabilities and additional mental health problems. Yet, few receive training in mental health, and evidence about the effectiveness of training is scant.Materials and Methods  A pre–post study is reported, using a mental health screen and a self‐report questionnaire to examine staff awareness of mental health problems and to measure whether training improved knowledge of psychopathology, attitudes towards mental health services and referral decisions.Results  Prior to training, deficits in awareness were evident. The Psychiatric Assessment Schedule for Adults with a Developmental Disability (PAS‐ADD) Checklist detected significant psychopathology in approximately one‐third of the individuals judged to have no mental health problems according to staff. Four months after the delivery of training, significant improvements in knowledge, attitudes and referral decisions were observed.Conclusion  Brief training interventions may improve awareness of mental health problems, but further research is needed to understand the referral process and to demonstrate the role of training in influencing actual staff behaviour.

The Camberwell Assessment of Need for adults with Developmental and Intellectual Disabilities (CANDID) is a widely used tool for the assessment of health and social needs of people with intellectual disabilities and mental health problems. It uses the assessment approach adopted by CAN, the world's leading mental health needs assessment measure. Two versions of the CANDID are available: CANDID-S (short version) and CANDID-R (research version). Both versions are aimed at researchers and practitioners working with people with intellectual disabilities, and are suitable for clinical use in community and hospital-based services. Fully updated based on current policy, practice and terminology, this second edition introduces a more intuitive need rating system and an accessible rating algorithm. Guidance on how to use the measures is provided, as well as an overview of research developments since the first edition. The assessment forms are freely available to download from the CAN website (researchintorecovery.com/can) and cambridge.org.

The CANDID is a needs assessment tool specifically designed for adults with intellectual disabilities and mental health problems. It was developed by modification of the CAN, the world's leading mental health needs assessment measure. Fully updated, this second edition is aimed at mental health, social care and management professionals.

Background Previous evidence has suggested that clinical characteristics may predict use of restraint in adults with intellectual disability. However, the relationship between specific types of untoward incidents, corresponding interventions (restrictive procedures) and clinical psychopathology remains unclear.Method We examined all untoward incidents (n = 397) that were recorded for a group of service users (n = 65) referred to a specialist unit for adults with intellectual disability over a 6‐year period. Associations between different restrictive procedures and clinical psychopathology were investigated.Results Physical assault was the most common incident associated with physical restraint, male gender and presence of autism. De‐escalation was the most frequently employed intervention associated with less serious incidents such as verbal abuse and theft.Conclusions Specific interventions seem to be associated with different types of incidents and presence of autism. The results are discussed in terms of clinical practice and possible future directions.

Background  Although there is already information available about caring for someone with a mental health problem, there is very little written for families and carers of people with intellectual disabilities.Materials and methods  This paper describes the development of a Guide as such a resource. The consultation stage involved interviews and focus groups with families, service users and paid carers (n = 20) to highlight their needs and preferred format. Additional carers (n = 12) completed structured questionnaires to evaluate the Guide.Results  The initial consultation showed that an easily accessible and user‐friendly information resource was needed. The evaluation showed that family carers were satisfied with the Guide, finding it easy to read and covering most of the information required. However, they did highlight areas that needed further detail.Conclusions  The involvement of carers in the development of such resources is essential, emphasizing the benefit of carers' knowledge and experience to professionals.

AbstractThere is little information on the mental health needs of adults with intellectual disability (ID) and autism spectrum disorders (ASDs). Such evidence is much needed for the development of more effective mental health services for this group. The aim of this study is to compare adults with ID and ASD receiving specialist mental health services with participants without ASD. Data were collected from the anonymized case records of a clinic‐based population in South East London. Health and social functioning were measured using the Health of the Nation Outcome Scale for people with Learning Disability (HoNOS‐LD). A review of case records identified 371 service users in receipt of specialist mental health care who were eligible for the study. There were 117 people (32% of the sample) with a clinical diagnosis of ID and ASD. Participants with ASD were younger, more likely to be male, less likely to live independently and had more severe ID than those without ASD. Furthermore, those with ID and ASD were less likely to be diagnosed with a psychiatric disorder but had significantly higher scores on the HoNOS‐LD (indicating lower health and social functioning) than those without ASD. A significant proportion of adults with ID who are in receipt of specialist mental health services also have a clinical diagnosis of ASD. This group has different mental health needs compared with those without ASD. The authors note the need for a more personalized approach to service delivery with a focus on improving social functioning and behavioral impairments.