Mental Health
Section: Mental Health | LD Toolkit template | RCGP Learning
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Mental Health
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People with a learning disability are more likely than the general population to experience common mental health problems, neurodivergence and severe mental illness and are more likely to have antipsychotic medication prescribed. People with lower intellectual ability have higher rates of symptoms of common mental health problems (25%) compared to those with average (17.2%) or above average (13.4%) intellectual functioning. One study found that 54% of people with a learning disability have a mental health problem. Children with a learning disability are four and a half times more likely to have a mental health problem than children without a learning disability.
Mental Health Foundation: people with learning disabilities - statistics
Royal College of Psychiatrists: intellectual disabilities
Southern Health NHS: how to stay well - looking after your mental health
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People with a learning disability are more likely to be neurodivergent than the general population and are less likely to have this recognised or have a diagnosis.
RCGP curriculum page: neurodevelopmental conditions and neurodiversity
RCGP blog: my journey from GP to neurodevelopmental specialist
RCGP neurodiversity special interest group
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Anxiety and depression are more common in people with a learning disability.
Mental health foundation: what can we do to cope with feelings of anxiety?
NICE Guidance NG53: mental health problems in people with learning disabilities (for the public)
Leicestershire Partnership NHS: mental health and learning disabilities
NHS BSW ICB: autism training - anxiety, depression and suicide; alexithymia (Youtube video)
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People with a learning disability are younger when they get memory problems, and we need to look at the possibility of dementia from age 50 onwards. People with Down's syndrome may be at risk of memory concerns from age 35. There are challenges in the identification and assessment of memory problems and delirium may be more challenging to recognise. People may need a joint response from community learning disability teams and memory clinics.
Emedicinehealth: Alzheimer's disease in Down syndrome
Down's Syndrome Association: ageing & dementia
Alzheimer's Society: learning disabilities and dementia
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Many people with a learning disability experience loss at a younger age, particularly as some of their friends may have complex medical conditions. There may also be the added challenge of being able to understand the feelings of loss and sadness and how to communicate.
Cruse Bereavement Support: supporting people with learning disabilities through grief
Learning Disability Nursing: awareness of and access to services, including bereavement support
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The following resources may help to reduce levels of inappropriate prescribing of antipsychotics.
Humber Teaching NHS Foundation Trust: disability distress assessment tool
Medications and my mental health
University of Birmingham: medicine information - learning disabilities medication guideline
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People with a learning disability may not have the words to describe how they are feeling, which is a particular problem for people with a learning disability who communicate without words. They may present with 'challenging behaviour' such as unsual agression or agitation or head banging. Rather than prescribing psychotropic medication consider if there could be other causes for a change in behaviour. Could they have dental pain? Could other life events be causing distress, such as a bereavement, a recent move or a change in friendship groups? Could they be badly constipated? Families or others who know them well may have ideas which can help work out what is happening.
The Challenging Behaviour Foundation
NHS BSW ICB: autism training - sensory overwhelm leading to emotional distress (Youtube video)
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Disturbed sleep is common in people with a learning disability and it is thought that up to 80% may have signficant sleep distrubances. The causes are likely to be multifactorial including seizure activity, sleep apnoea related to weight, reflux and problems with digestion.
Great Ormond Street Hospital for Children: getting a good night's sleep (Easy Read)
NHS Pennine Care: sleep problems (Easy Read)
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A restricted diet, perhaps due to sensory issues or concern about trying new foods, can be a problem in some people with a learning disability, potentially leading to vitamin/mineral deficiencies and their medical consequences.
BJGP life: what is avoidant restrictive food intake disorder?
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People with mental health problems and learning disabilities are overrepresented in the criminal justice system. The identification of people with learning disabilities, both by police custody staff and custody healthcare staff can be poor.
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