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Background: People with learning disabilities have poorer access to mental health services. It is important for health and social care professionals to have adequate knowledge and skills combined with positive attitudes to work with this population. This review focuses on the knowledge, attitudes and perceptions of health and social care professionals who provide mental health services to people with learning disabilities. Method: A systematic literature search was carried out to identify quantitative studies published in the English language between 2006 and 2020. Results: Thirteen studies were identified that met the inclusion criteria. The studies identified a lack of knowledge and competency among health and social care professionals to address the mental health needs of people with learning disabilities. Health and social care professionals in these studies viewed people with learning disabilities are more vulnerable and suggested specialist mental health services to cater to their specific mental health needs. Conclusions: Health and social care professionals appear to hold negative views of people with learning disabilities, which adversely influences their willingness to work with them. It is recommended that health and social care professionals receive more training opportunities to increase their skills and develop confidence in providing services to this population.

Background: Mental health professionals play an important role in providing care and treatment for adults with intellectual disabilities. A number of studies use qualitative methods to explore the experiences of these professionals and their perspectives regarding the mental health services for this population. A systematic review using meta-ethnographic approach was undertaken to summarise this research. Method: A systematic search found 14 relevant studies which were critically appraised. Key themes from these studies were extracted and synthesised. Results: Three main themes were identified: 1) Understanding the person, 2) Relational interaction and 3) Organisational factors. Conclusions: The findings of this review identified the issues mental health professionals raised in relation to their work. They described the complex presenting problems as intense yet fulfilling therapeutic relationships with their clients and their wish to improve their knowledge and skills. They identified organisational issues that need to be addressed to improve staff morale and efficiency.

Introduction: This research investigated the views of different stakeholders regarding the specialist mental health service for people with intellectual disabilities (ID) in Singapore. Method Interviews were conducted with mental health professionals, family carers and service users with ID. Framework analysis was adopted to identify common dominant themes among the different participant groups. Results Analysis revealed four themes (1) Giving choice and autonomy; (2) Training to become competent; (3) Respect; and (4) Part of the community Conclusions People with ID living in Singapore have limited opportunities to express their choices and autonomy especially when it comes to treatment planning. Family carers have a significant influence on the level of community presence of their relatives with ID. Participants identified employment for people with ID as a way to improve public perceptions. There was no mention of people with ID developing social relationships. Recommendations are discussed in the context of current service provision.

Recent COVID-19 lockdown restrictions resulted in reduced access to educational, professional and social support systems for children with intellectual disabilities and their carers. Aim: The aim of this study was to gain insight into the ways mothers of children with intellectual disabilities coped during the first 2020 lockdown period. Methods: Eight mothers of children with intellectual disabilities were interviewed. The recordings of these interviews were subjected to a thematic analysis. Results: Three main themes were identified: carrying the burden; a time of stress; and embracing change and looking to the future. Conclusions: All mothers experienced increased burden and stress. However, some also described some positive impact of lockdown conditions on them as well as on their child's well-being and behaviour. These findings are discussed in the light of the (Journal of Applied Research in Intellectual Disabilities, 33, 2020, 1523) survey results on parental coping and suggestions for future service provision during pandemic conditions are proposed.

Background: Generic mental health staff often have contact with people with intellectual disabilities when they access mainstream mental health services. To date, there has not been any research conducted in nonwestern countries to explore their views. This paper investigates the views and experiences of mainstream mental health professionals regarding the mental health services for people with intellectual disabilities in Singapore. Methods: Eight staff members from generic mental health services were interviewed. Thematic analysis was used to identify main themes. Findings: The main themes are related to their work experiences, perceptions of people with intellectual disabilities, ideal staff characteristics and service recommendations. Conclusions: Participants identified a lack of experience and knowledge when working with this population. They highlighted the challenges they face promoting choice and autonomy for people with intellectual disabilities. The discussion includes recommendations for improving staff knowledge through training opportunities, consideration of non-pharmacological approaches and early collaboration with caregivers during the treatment process.

It is imperative that we devote resources and research effort to find out what is going on in families where there is a member with Intellectual and Developmental Disabilities (IDD) over the course of the COVID 19 pandemic and how adaptations can be made to provide the most effective help. This article discusses the need for more research to be done in this area. The authors share their current research that they are conducting, and they explain future steps to continue this research.

Introduction: The measures implemented to manage the COVID-19 pandemic have been shown to impair mental health. This problem is likely to be exacerbated for carers. Method: Informal carers (mainly parents) of children and adults with intellectual disabilities, and a comparison group of parents of children without disabilities, completed an online questionnaire. Almost all the data were collected while strict lockdown conditions were in place. Results: Relative to carers of children without intellectual disability, carers of both children and adults with intellectual disability had significantly greater levels of a wish fulfilment coping style, defeat/entrapment, anxiety, and depression. Differences were 2-3 times greater than reported in earlier pre-pandemic studies. Positive correlations were found between objective stress scores and all mental health outcomes. Despite their greater mental health needs, carers of those with intellectual disability received less social support from a variety of sources. Conclusions: The greater mental health needs of carers in the context of lesser social support raises serious concerns. We consider the policy implications of these findings.

Background: Eye movement desensitization and reprocessing (EMDR) is recommended for post-traumatic stress disorder and emerging evidence indicates that it is effective for people with intellectual disabilities. However, acceptability from the perspectives of clients with intellectual disabilities, their therapists and other key people has not been formally evaluated. This study investigates process issues in the implementation of EMDR from perspectives of multiple stakeholders. Method: Semi-structured interviews were conducted with two adults with intellectual disabilities and three clinical psychologists who had participated in EMDR as well as a key supporter (N = 6) to provide information relating to three cases. The interviews were analysed thematically either directly from the audio recording or from transcripts. Results: Five themes were identified: EMDR feels very different; EMDR is a technical process; the need to work with the present; talking is important; cautious optimism. Conclusions: Whilst a range of client- and therapist-related factors served as barriers to using EMDR in this small-scale study, such as preferences in working with the present and inexperienced therapists, there was cautious optimism that EMDR may be useful for "the right person at the right time.".

Objectives: To explore how much people with Asperger's syndrome know and understand about early attachment behaviors and whether this knowledge can be increased through a DVD. Methods: Adults with Asperger's syndrome who were not parents (N = 28) took part in four experimental conditions: Baseline, pre-intervention, post-intervention, and follow-up. Participants watched a DVD and received a booklet summarizing its contents. Participants were asked seven questions about attachment in all four conditions. Measures of trait emotional intelligence, IQ and autistic symptomatology were explored as possible predicting factors. Results: A significant increase in knowledge of early attachment behaviors was observed at post-intervention for the total knowledge score and four out of the seven attachment questions. This was maintained at follow-up. Trait emotional intelligence, IQ and autistic symptomology did not predict pre-intervention or increase in knowledge. Conclusions: Knowledge and understanding of early attachment behaviors can be improved through the use of a DVD.

Background: Previous research has largely focused on evaluating the impact of teaching practical parenting skills to parents with intellectual disabilities. Teaching them about the importance and nature of early attachment behaviors has not yet been explored. This study investigates whether knowledge of early attachment behavior of young adults with an intellectual disability who are not yet parents, can be increased using an educational DVD. Method: A sample of students with intellectual disabilities (N = 25) were asked to complete the 'parent-child questionnaire' at three stages: pre-intervention, post-intervention, and two to three week follow-up. The questions that make up this questionnaire relate to early attachment behaviors. Results: Statistical analyses show that there was a statistically significant increase in knowledge of attachment behavior following the intervention (t(24) = -3.48, p < 0.05) and this increase was maintained at follow-up (t(24) = -3.27, p < 0.05). Increase in knowledge was not significantly associated with any of the demographic factors (gender, age, intelligence quotient, main carer, number of siblings, family history of intellectual disabilities, and previous teaching on childcare). Conclusion: It is concluded that the use of an educational DVD is an effective way of teaching young adults with an intellectual disability about early attachment behaviors between parents and young babies.

Objectives: To explore the perspective of adults with intellectual disabilities from minority ethnic groups, on their relationship with social care services. Methods: Thirty-two adults took part in semi-structured interviews. Transcripts were analyzed within a Pluralist framework, adopting the structure of Template Analysis and then drawing on phenomenological, narrative, and discursive approaches. Results: Our participants were generally positive about the services which they received, which they evaluated primarily in terms of their continuing good relationship(s) with specific workers. Our respondents were sophisticated users of cultural resources and identities; the concept of 'cultural affordance' may be useful alternative to 'cultural competence'. We discuss three distinctive narratives about independence (Stability; Progress; Resistance). Each highlights the importance of maintaining connectedness to others, and the crucial role played by ownership of decision-making. Conclusions: We have developed a set of resources which service providers (and researchers) can use with people with intellectual disabilities, in order to support mutual understanding, service planning and delivery.

Background: While psychologists working with people with an intellectual disability routinely work with care staff in residential care homes there is a lack of research investigating how psychologists can effectively assess, collaborate, and engage with staff groups. Aims: This research seeks to explore psychologists' experiences of working with staff in residential care homes in order to develop an understanding of how psychologists manage the work and to help generate clinical solutions to psychological problems. Methods: Seven clinical psychologists and one counseling psychologist were interviewed using a semi-structured interview focusing on participants' interactions with staff. Interviews were transcribed and analyzed using Interpretative Phenomenological Analysis. Findings: Themes common across participants included 'development and maintenance of a therapeutic relationship,' 'theory and emotion,' 'perceived restrictions,' 'safety,' 'developing an identity as a psychologist,' 'support and shared experiences,' 'motivation,' and 'conflict and the roles of a psychologist.' Conclusions: Participants experienced several barriers to carrying out effective psychological work with staff in residential care homes. The various ways they have sought to address these are discussed. A preliminary model is proposed to describe what is needed for psychologists to be effective when working with staff in residential care homes.

Background: With increasing numbers of people with an intellectual disability choosing to become parents, the right support is imperative for effective parenting (Macintyre & Stewart2011]). The aim of this study was to gain insight into the experiences of parents who received support from Doulas during pregnancy, birth and following the birth of their child. In addition, the experiences of the Doulas who provided the support were investigated. Materials and Methods: Four women with an intellectual disability who received Doula support were interviewed before and after the birth of their child. Three Doulas were interviewed after the birth about their experiences of supporting women with an intellectual disability. Results: Interview transcripts were analysed using Interpretive Phenomenological Analysis (IPA). Themes were identified from each interview, before an overall analysis of themes from each support phase was undertaken. Conclusions: Pre-natally, the Doula was considered helpful and a reliable source of information about pregnancy. Each mother perceived Doula support as a means of keeping her child in her care. Post-natally, mothers described a trusting relationship with their Doula, who enabled them to make informed choices. Doulas described how they adapted their work to meet the needs of parents with intellectual disability. Being involved in Child Protection procedures was perceived as stressful and challenging.

Background: Many people with intellectual disabilities display high levels of anger, and cognitive-behavioural anger management interventions are used routinely. However, for these methods to be used optimally, a better understanding is needed of different forms of anger assessment. The aim of this study was to investigate the relationship of a range of measures to self- and carer reports of anger expression, including instruments used to assess mental health and challenging behaviour. Method: Adults with intellectual disabilities, who had been identified as having problems with anger control, their key-workers and home carers all rated the service users' trait anger, using parallel versions of the same instrument (the Provocation Inventory). In addition, service users completed a battery of mental health assessments (the Glasgow Depression Scale, Glasgow Anxiety Scale and Rosenberg Self-Esteem Scale), and both groups of carers completed a battery of challenging behaviour measures (the Hyperactivity and Irritability domains of the Aberrant Behavior Checklist and the Modified Overt Anger Scale). Results: Participants had high levels of mental health problems (depression: 34%; anxiety: 73%) and severe challenging behaviour (26%). Hierarchical linear regression analysis was used to explore the extent to which anger ratings by the three groups of respondents were predicted by demographic factors, mental health measures and challenging behaviour measures. Older service users rated themselves as less angry and were also rated as less angry by home carers, but not by key-workers. More intellectually able service users were rated as more angry by both sets of carers, but not by the service users themselves. Significantly, mental health status (but not challenging behaviour) predicted service users' self-ratings of anger, whereas challenging behaviour (but not mental health status) predicted carers' ratings of service users' anger. Conclusions: Service users and their carers appear to use different information when rating the service users' anger. Service users' self-ratings reflect their internal emotional state and mental health, as reflected by their ratings of anxiety and depression, whereas staff rate service users' anger on the basis of overt behaviours, as measured by challenging behaviour scales.

Background: It has been suggested that inequalities in health care for people with intellectual disabilities may be partly explained by negative attitudes of health professionals. This study aimed to investigate the attitudes and emotional reactions reported by nursing staff working in general hospitals towards caring for patients with intellectual disabilities. Method: Attitudes and emotional reactions were measured using a self-report, vignette style questionnaire, tested for validity and reliability. Attitudes towards patients with physical disabilities were also assessed to act as a comparison. Results: Nursing staff reported less positive attitudes, more negative emotions and fewer positive emotions, in response to caring for a patient with an intellectual disability compared to a patient with a physical disability. Occupational status (registered general nurse, student nurse, nursing assistant) had no effect upon respondents reported attitudes or emotions. Finally, attitudinal and emotional variables were significantly correlated, with positive emotions being associated with more favourable attitudes. Conclusions: Although caution needs to be exercised when inferring actual behaviour from attitudes expressed, it is suggested that the presence of less positive attitudes and feelings amongst nursing staff towards patients with intellectual disabilities may affect the quality of care. Recommendations for future research and service development includes: the need to focus upon improving attitudes of nursing staff through training, and increased joint working between acute care services and Community Intellectual Disability Teams.

Less is known about the process of desistance from crime for females within the criminal justice system. The current study explored the views and experiences in a sample of adult female offenders in the UK. Ten women took part in semi-structured interviews. Data were analyzed using thematic analysis. The following themes were identified: Skills and Attributes; Support; Purpose in Life; Risk Factors; and Consequences. The findings provide support for existing theories of desistance including cognitive transformation theory, social control and identity theory of desistance. The findings add to the growing evidence in the field of desistance from crime in female offenders. [ABSTRACT FROM AUTHOR]