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15th August 2014

Breaking Down Barriers

Broken WallThere is report, published recently by the Foundation for People with Learning Disabilities, that reviews the help available for people with both a learning disability and a mental health problem, and the difficulties in accessing this. The report, Feeling Down, is the result of a survey amongst service users, their families and professionals, as to how well services respond to the mental health needs of people who have both a learning disability and a mental health problem.

Barriers to mental health services

One of the traditional barriers to getting a good mental health service for people who also have a learning disability has been two services working in isolation, and service users being categorised into one client group or another. There has been a lot of improvement here and much more evidence of joint working, and the work of the Green Light project which I’ve blogged about before (Getting the Green Light 23.12.2013) has done a lot to break this barrier down. However there are still lots of other barriers that this report highlights such as:

  • Changes in behaviour being seen as ‘challenging behaviours’ when these may be the symptoms of a mental health problem.
  • Not making referrals to newer psychological therapy services for more common mental health problems, perhaps because people with learning disabilities aren’t seen as appropriate for referral.
  • Services not being able to ‘see beyond the learning disability’ and so mental health problems are not identified.

The report contains some very powerful case studies with some useful messages for care providers:

  • Sometimes people find it difficult to describe mental health symptoms, so be aware of some physical symptoms in the stomach or the head that might indicate a mental health problem.
  • When working with service users care staff should be able to follow up on guidelines and advice from psychologists and other mental health professionals.


The report makes a number of recommendations, and there are a few of these that I think care service providers should be aware of:

  • Providers should be aware of the recommendations of the Michael report. This report followed an inquiry into premature deaths of people with learning disabilities. This report was mainly about the physical healthcare of people with learning disabilities, but many of the messages could equally be about mental health services working better together.
  • People with a learning disability should have regular health checks and these should include mental health checks.
  • Providers should know the provisions of mental capacity and equality laws, as these provide a framework for getting services to people.

The Feeling Down report can be viewed at:

*All information is correct at the time of publishing

Topics: Mental Health

David Beckingham

Mental Health Specialist

David Beckingham is a self-employed independent trainer, and is also an honorary lecturer with the University of Cumbria. His professional background is as a social worker and he has worked in care homes for older people in Cumbria. David’s main area of expertise is in mental health. Prior to becoming self-employed he was a Staff Development and Training Officer with Cumbria County Council, both commissioning and delivering training to mental health workers and others in statutory and independent sector organisations. Read more

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