People with learning disabilities being adversely affected by austerity is a source of shame

Background Mental ill-health is more prevalent among adults with intellectual disabilities (ID) than in the wider population. An interest in the mental health needs of people with ID has developed in recent decades, which corresponds with implementation of the health and social policy of deinstitutionalisation. Much clinical and research activity has focused on how such mental health needs may be addressed. The literature indicates that the views of people with ID concerning their mental health care have received limited attention.

Aim To describe the adaption of a psychosocial research approach (Hollway and Jefferson 2000, 2013), and discuss the methodological challenges encountered in enabling adults with intellectual disabilities (ID) to express their views and be actively involved in producing knowledge about their experiences of care and support as service users with diagnosed mental health needs.

Discussion A considerable advantage of the interview format of this psychosocial approach was the opportunities it afforded participants to recount their personal stories. This is contrary to the question-and-answer technique of interviewing, which can suppress the stories of interviewees. In such structured approaches, the interviewer establishes the boundaries and usually maintains control over the production of data.

Conclusion Undertaking two research interviews with participants, analysis of the entire material regarding individual participants, and undertaking comparative analysis of data relating to all participants provided a system for checking consistency. This approach therefore provides a valid method for enabling the participation of people with ID.

Implications for practice The approach used is congruent with the requirement for the subjectivities of researchers – and those being researched – to be acknowledged, which is central to disability research. It is also compatible with person-centred planning and coproduction, which are central to contemporary ID nursing practice.

Seven years ago, recommendations were made to ensure a safer future of learning disability nursing in the NHS. Here, professor of learning disabilities Bob Gates considers whether anything has changed. 

Epilepsy is relatively common in people with learning disabilities, and can be complex and refractory to treatment, with negative effects on quality of life and service costs. This article describes a randomised controlled feasibility trial, called Wordless Intervention for Epilepsy in Learning Disabilities, under way at Hertfordshire Partnership University NHS Foundation Trust. Recruitment of people with learning disabilities and epilepsy to the trial has been affected by logistical issues, such as difficulties in identifying potential patients and contacting carers. However, public and patient involvement has improved study design and management, and has helped maximise recruitment. Should the present study confirm feasibility, a full-scale randomised controlled trial will address the effects of the Books Beyond Words title Getting on With Epilepsy as an intervention for people with learning disabilities and epilepsy.

<p>This article describes a survey of the views of clients, carers and hospital staff about the learning disability liaison nurse role in an acute hospital in the south of England. The survey found that the service benefits people with learning disabilities, particularly during admission, as well as their families and carers. Good communication is vital for effective health provision, however, and if communication barriers associated with learning disability are not overcome, clients can receive poor care. The positive evaluation of the liaison nurse role discussed in this article confirms the need for their presence in acute hospital and similar settings to improve communication and collaboration between clients, families, carers, doctors and ward staff.</p>

<p>A well educated and trained workforce is central to the development of quality care for people with learning disabilities. Unsure of the demand for educational programmes for pre-registration learning disability nursing, South Central Strategic Health Authority commissioned the Valued People Project to undertake a detailed review of educational commissioning and the specialist learning disability health workforce. The project provided an evidence-based evaluation of the future direction of education commissioning and leadership in specialist learning disability services, as well as the wider NHS workforce.</p> <p>This article reports on one aspect of the project; the semi-structured interviews and focus group work with commissioners, managers and practitioners of learning disability services about the specialist health workforce needed to support this group and their families in the future. It identifies strong support for a specialist NHS workforce, mirroring findings from people with learning disabilities and their parents (Gates and Waight 2010).</p>