Ellie Matthews

Services available for patients with L.D

200

What are some of the services available in addressing learning disabilities? 

Primary care–GP

Secondary care–General hospital, community learning disability team, assessment and treatment unit

Independent sector e.g.WARD family trust

Advocacy

Respite

Social services–involved in housing, finance etc

300

What are some ways to include people with L.D in leisure activities (and therefore provide them with increased opportunities for forming friendships)?

1. Awareness training of staff – Training staff to understand the needs to people with a learning disability remains an important component towards improving the experiences of people with learning disabilities. This can lead to better communication and knowledge of how activities can be made accessible and inclusive. 
2. Easy read information – Providing easy-read information about leisure activities would make information about leisure activities more accessible and hence, more inclusive. This includes ensuring websites are accessible for people with a learning disability.
3. Transport and mobility – Greater funding for resources and transport would lead to more innovation and better services for people with a learning disability. More accessible transport options can increase opportunities to participate in leisure activities
4. Improving access of spaces and places – Service providers have a duty to make reasonable adjustments to ensure disabled people are not substantially disadvantaged when compared to non-disabled people. People with a disability should be involved in the design of venues and facilities, in order to meet the needs of people with different impairments
5. Participating in leisure projects – People with a learning disability should be encouraged to participate in leisure projects. (For example, MENCAP projects)  

400

In a survey by Sense, over half of disabled people reported feeling lonely, rising to over three quarters (77%) for those aged 18-34 (Sense 2017). 

Why are friendships important to people with a L.D ?

More happiness and confidence: Having an active social life can help people with a learning disability to feel happier, included and valued 

Reduce loneliness: Friendships also help to reduce loneliness. Loneliness is linked to  a number of health risks, such as depression, high blood pressure and higher mortality risk

Improved health: Evidence suggests that having more and better quality friendships is associated with better physical health and lower risk of early mortality 

Presentations of mental illness in individuals with significant L.D

200

What is the definition of a learning disability ?

Significantly reduced ability to understand new or complex information and to learn and apply new skills (impaired intelligence). 

This results in a reduced ability to cope independently (impaired social functioning), and begins before adulthood, with a lasting effect on development.

300

What are some reasons why mental health problems are not always recognised in people with L.D.?

• There is a gap between mental health services and learning disability services.
• Assessments to detect mental health problems in people with a learning disability are not always well developed
• When symptoms presented by someone with a learning disability are attributed to their learning disability, rather than the true problem
• Staff supporting people with a learning disability “are likely to use a challenging behaviour rather than a mental health conceptual framework to understand problematic behaviours”.

400

What are some of the reasons why people with L.D’s are more likely to have poorer mental health ?

Accumulation of negative life events over the life course results in higher levels of stress, which can increase risk of developing mental health problems 

This can result in changes in behaviour such as distress, irritability and agitation (NICE, 2016).

Biological factors - Pain, physical ill health and taking multiple types of medication can all contribute to poor mental health. Some genetic syndromes are associated with specific mental health problems 

Negative life events  - People with a learning disability may be more likely to experience deprivation, poverty, abuse and other negative life events earlier on in life 

Fewer resources – Lack of social support and reduced coping skills are associated with depression and anxiety in people with a learning disability. This can increase the stress and burden felt by people with a learning disability when they are exposed to negative life events

Other people’s attitudes  – Stigma and discrimination can become internalised, which can result in psychological distress

How needs of individuals with L.D interact with the health care environment

200

What adjustments can be made for people with L.Ds when seeing a doctor 

• using pictures, large print or simpler words to say what's happening
• booking longer appointments 
• having a carer with them
• putting an appointment at the beginning or end of the day, if they find it hard to be in a busy waiting room

300

What are some challenges specific to people with L.D?

• Difficulties accessing screening, primary care & dental services

• Underreporting 

• Lack of reasonable adjustments 

• Physical access to some environments 

• Diagnostic overshadowing 

• Problems with DNACPR (do not attempt cardiopulmonary resuscitation) 

• Lack of accessible information 

• Delays in diagnosis and treatment 

• Undiagnosed or misdiagnosed illness 

• Lack of awareness of LD issues in wider NHS workforce 

• Families not listened to 

• Poor communication between different providers 

• Poor communication & relationships between professionals, carers and families

400

Why is it important for people with L.D to see their GP for an annual check up ?

People with a learning disability often have poorer physical and mental health than other people. 

Everyone over the age of 14 who is on their doctor's learning disability register has an annual health check

Epidemiology of common L.D

200

What percentage of the UK have LD ?

Roughly 2% 

300

Having a learning disability increases the risk of .....?

Dementia (21.6% compared to 5.7% aged 65+, and more likely to develop when younger)

Schizophrenia 

Anxiety and depression

More likely to die from an avoidable cause (38% vs. 9%)

400

What percetange of people (aged between 16-64) with L.D’s are in paid employment (2017/2018) ?

6% of people with L.D (7,907 people) 

compared to 76% of people in the general population (16-64)