Adults with Intellectual Disabilities and Mental Health Disorders in Primary Care: a Scoping Review

Overview

Journal Br J Gen Pract

Specialty Public Health

Date 2021 Dec 14

PMID 34903519

Citations 6

Authors

Katrien Pm Pouls

Monique Cj Koks-Leensen

Mathilde Mastebroek

Geraline L Leusink

Willem Jj Assendelft

Affiliations

Soon will be listed here.

Abstract

Background: GPs are increasingly confronted with patients with both intellectual disabilities (ID) and mental health disorders (MHD). Currently, the care provided to these patients is found to be insufficient, putting them at risk of developing more severe MHD. Improving the quality of GP care will improve the whole of mental health care for this patient group. Therefore, an overview of the content and quality of care provided to them by the GP may be helpful.

Aim: To provide an up-to-date literature overview of the care provided by GPs to patients with ID and MHD, identify knowledge gaps, and inform research, practice, and policy about opportunities to improve care.

Design And Setting: Scoping review.

Method: PubMed, PsycINFO, EMBASE, and grey literature were searched for publications concerning primary care and patients with ID and MHD. Selected publications were analysed qualitatively.

Results: One hundred publications met the inclusion criteria. Five overarching themes were identified: GP roles, knowledge and experience, caregiver roles, collaboration, and a standardised approach. The results show GPs' vital, diverse, and demanding roles in caring for patients with both ID and MHD. GPs experience problems in fulfilling their roles, and gaps are identified regarding effective GP training programmes, applicable guidelines and tools, optimal collaborative mental health care, and corresponding payment models.

Conclusion: The improvement required in the current quality of GP care to patients with ID and MHD can be achieved by bridging the identified gaps and initiating close collaborations between care professionals, policymakers, and organisational managers.

Citing Articles

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Primary mental health care for adults with mild intellectual disabilities: a focus group study of care professionals' perspectives.

Pouls K, Mastebroek M, Ligthart S, Assendelft W, Koks-Leensen M, Leusink G BJGP Open. 2024; 8(4).

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Primary mental healthcare for adults with mild intellectual disabilities: Patients' perspectives.

Pouls K, Mastebroek M, Ligthart S, Assendelft W, Leusink G, Koks-Leensen M Eur J Gen Pract. 2024; 30(1):2354414.

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Barriers to Mental Health Care Transition for Youth and Young Adults with Intellectual and Developmental Disabilities and Co-occurring Mental Health Conditions: Stakeholders' Perspectives.

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PMID: 38619698 PMC: 11199219. DOI: 10.1007/s10597-024-01262-x.

Primary mental healthcare for adults with mild intellectual disabilities: a Dutch database study.

Pouls K, Koks-Leensen M, Assendelft W, Mastebroek M, Leusink G Eur J Gen Pract. 2022; 28(1):234-241.

PMID: 36412308 PMC: 9683063. DOI: 10.1080/13814788.2022.2142936.

References

Sheehan R, Hassiotis A, Walters K, Osborn D, Strydom A, Horsfall L . Mental illness, challenging behaviour, and psychotropic drug prescribing in people with intellectual disability: UK population based cohort study. BMJ. 2015; 351:h4326. PMC: 4556752. DOI: 10.1136/bmj.h4326. View

Davis R, Mohr C . The assessment and treatment of behavioural problems. Aust Fam Physician. 2004; 33(8):609-13. View

Trollor J, Salomon C . Unnecessary psychotropic drug prescription in primary care for people with intellectual disability. Evid Based Ment Health. 2016; 19(2):62. PMC: 10699427. DOI: 10.1136/eb-2015-102245. View

Cooper S, Hughes-McCormack L, Greenlaw N, McConnachie A, Allan L, Baltzer M . Management and prevalence of long-term conditions in primary health care for adults with intellectual disabilities compared with the general population: A population-based cohort study. J Appl Res Intellect Disabil. 2017; 31 Suppl 1:68-81. DOI: 10.1111/jar.12386. View

Holden B, Gitlesen J . Psychotropic medication in adults with mental retardation: prevalence, and prescription practices. Res Dev Disabil. 2004; 25(6):509-21. DOI: 10.1016/j.ridd.2004.03.004. View

Torr J, Iacono T, Graham M, Galea J . Checklists for general practitioner diagnosis of depression in adults with intellectual disability. J Intellect Disabil Res. 2008; 52(11):930-41. DOI: 10.1111/j.1365-2788.2008.01103.x. View

Martin D, Roy A, Wells M . Health gain through health checks: improving access to primary health care for people with intellectual disability. J Intellect Disabil Res. 1997; 41 ( Pt 5):401-8. DOI: 10.1111/j.1365-2788.1997.tb00727.x. View

McGillivray J, Kershaw M . The impact of staff initiated referral and intervention protocols on symptoms of depression in people with mild intellectual disability. Res Dev Disabil. 2012; 34(2):730-8. DOI: 10.1016/j.ridd.2012.11.005. View

van Duijvenbode N, VanDerNagel J . A Systematic Review of Substance Use (Disorder) in Individuals with Mild to Borderline Intellectual Disability. Eur Addict Res. 2019; 25(6):263-282. PMC: 6888885. DOI: 10.1159/000501679. View

10.

Gijssel E, Leusink G . [Psychotropic drug prescription to people with intellectual disability in GP practices]. Ned Tijdschr Geneeskd. 2015; 159:A9754. View

11.

Mastebroek M, Naaldenberg J, van den Driessen Mareeuw F, Lagro-Janssen A, van Schrojenstein Lantman-de Valk H . Experiences of patients with intellectual disabilities and carers in GP health information exchanges: a qualitative study. Fam Pract. 2016; 33(5):543-50. DOI: 10.1093/fampra/cmw057. View

12.

Whittle E, Fisher K, Reppermund S, Trollor J . Access to mental health services: The experiences of people with intellectual disabilities. J Appl Res Intellect Disabil. 2018; 32(2):368-379. DOI: 10.1111/jar.12533. View

13.

Seelen-de Lang B, Smits H, Penterman B, Noorthoorn E, Nieuwenhuis J, Nijman H . Screening for intellectual disabilities and borderline intelligence in Dutch outpatients with severe mental illness. J Appl Res Intellect Disabil. 2019; 32(5):1096-1102. DOI: 10.1111/jar.12599. View

14.

Sullivan W, Diepstra H, Heng J, Ally S, Bradley E, Casson I . Primary care of adults with intellectual and developmental disabilities: 2018 Canadian consensus guidelines. Can Fam Physician. 2018; 64(4):254-279. PMC: 5897068. View

15.

Lennox N, Eastgate G . Adults with intellectual disability and the GP. Aust Fam Physician. 2004; 33(8):601-6. View

16.

Salomon C, Britt H, Pollack A, Trollor J . Primary care for people with an intellectual disability - what is prescribed? An analysis of medication recommendations from the BEACH dataset. BJGP Open. 2018; 2(2):bjgpopen18X101541. PMC: 6184100. DOI: 10.3399/bjgpopen18X101541. View

17.

Prater C, Zylstra R . Medical care of adults with mental retardation. Am Fam Physician. 2006; 73(12):2175-83. View

18.

Alexander R, Shankar R, Cooper S, Bhaumik S, Hastings R, Kapugama C . Challenges and pitfalls of antipsychotic prescribing in people with learning disability. Br J Gen Pract. 2017; 67(661):372-373. PMC: 5519119. DOI: 10.3399/bjgp17X692081. View

19.

Martin B . Primary care of adults with mental retardation living in the community. Am Fam Physician. 1997; 56(2):485-94. View

20.

Hsieh H, Shannon S . Three approaches to qualitative content analysis. Qual Health Res. 2005; 15(9):1277-88. DOI: 10.1177/1049732305276687. View