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Mental Health And Intellectual Disabilities: Adult Social Care In England

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Mental Health And Intellectual Disabilities: Adult Social Care In England Question: Discuss about a Essay on Mental Health and Intellectual Disabilities for Adult Social Care in England?   Answer: Introduction Schizophrenia is a state of mental disorder where individual persist unusual social behaviour, reduced realistic expression, development of false beliefs and confused thought process. This disease is common in young adults and can last till mortality. Similarly, Intellectual or learning disabilities are another category of mental disabilities known as Intellectual Development Disorder (IDD) occurring due to reduced IQ below 70 with additional behavioral and cognitive defects (Johnstone, 2012). In this essay, the learner will analyse the care needs of schizophrenia and intellectual disabilities sufferers along with the study of the best possible care provisions to overcome these care needs. The services discussed in this study are Advocacy, community support services, standards for clinical care improvements and psychological interventions. According to Glasby (2012), these care provisions are appropriate to develop better care services, education, support system, cognitive improvements and behavioral modifications. These services are analysed to be the best care delivery mechanism for mental disabilities like schizophrenia and intellectual disabilities as per cultural and ethical sensitivity. Evaluating The Needs Of People With Specific Mental Health Problems And Disabilities In this section, the most specific and common needs of people suffering from Schizophrenia and intellectual disabilities are described: – Psychological Care Requirements It is been identified that the people with developmental or learning disorder develop psychological issues like lack of communication, personality disturbance, cognitive disabilities, the disorder in though process and many more, leading to the development of certain specific psychological care needs. The general intelligence diagnosis process involving in the identification of patient’s IQ score indicated that patient with Schizophrenia and learning disabilities have cognitive dysfunctions that involve speech handicaps, lack of quality standards in life, defects in memory, delays in oral language development and many other psychological defects that even lead to increasing mortality rate of patient (Jones et al. 2012). Another most important psychological care requirement is the emotional and psychological support that is generally lacking in the life of these patients due to isolation from family. They develop factors like low self-esteem, lack of confidence, lack of relationship desire, incapability to practice pleasure and lack of enthusiasm (Care Quality Commission, 2012). Need Of Standards In Hospital & Community Care The community care and health care standards play a very important role in care provision of schizophrenia, intellectual disability or any other mental disorder. Lawrence & Kisely (2010) studied the survey where 101 Schizophrenia patient’s were interviewed to understand their care needs out of which 58 people stated that they need care improvements in the clinical domain related to more liaison health care professionals, improved quality of treatment and the maintenance of more hygienic environment in hospitals. Some other handicaps that occur in care standards for people suffering from these learning disabilities are the lack of consultants in community care, adult psychiatry throughout the UK and lack of clinical management practices (Emerson, 2012).   Need Of Advocacy, Education, Social Care & Support People with learning disabilities and Schizophrenia often suffer from issues like social isolation, struggle to be attended, lack of proper education, personal support, bullying, unemployment, financial crisis and lacking professional support. These are the most basic and practical issues that are faced by the person having a cognitive imbalance (Kisner and Colby, 2012). Chadwick et al (2012) opines that as per British Institute of Learning Disabilities (BILD) the advocacy is a primary need for people with intellectual disability to achieve social standards. The fulfilment of advocacy will deliver supportive role in social care services. Stylianos and Kehyayan (2012) stated that the patient’s of Schizophrenia require proper education about their disease because this is a very complex state of mind where people generally do not understand the symptoms of their disease. The Education, Health and Care (EHC) plan helps to identify the education, health and care needs of people suffering from the intellectual disability and schizophrenia, that is further communicated to professional, family, consultant and supports to understand the needs of sufferers. The social care and support needs involve employment, action against isolation, removal of bullying from public spaces and defending their rights and responsibilities. Promoting Mental Health Care That Is Culturally And Ethnically Sensitive The social, political, cultural and demographic factors may either leave of positive or a negative impact on sufferers of mental disorder and development of their care provisions. In general understanding, the Social Drift Hypothesis stated that the people suffering from mental disorder are not considered as the complete citizen of society, especially sufferers of intellectual disabilities. The Schizophrenia people were analysed in studies of  Tsang et al. (2010) to be socially isolated with the lack of social network, adverse life events, deprivation and social harassment activities like bullying, violence, underestimation, family isolation and lack of housing. For control over such social isolations of schizophrenia and learning disabilities sufferers and developing self-determination, self-confidence the care provision of advocacy practices, community support and care homes are considered most ethical care practices for these patients. Until late 20th century, the children with intellectual disabilities were not allowed for routine public education and were isolated from normally developing children. Their education needs were not met leading to issues like unemployment, lack of communication skills, psychic life experiences and low rate of motivation with low living standards. Wiese et al. (2012) studied a survey where the high rate of unemployment was identified in Caribbean origin people that first presented schizophrenia in the UK. However, in the present situation there are special schools been developed for mental disorder sufferers, which were identified to develop similar levels of stigma as normal children along with great ambitions in career development prospect. Apart from this, there are special schools (SEN schools) for sufferers of intellectual disabilities to let them overcome their learning disabilities and handicaps. These schools properly follow the legal and ethical standards established by legislation of particular country to deliver education. The cultural and demographic of patient’s suffering from Schizophrenia and Intellectual disabilities affects the individuals communication methods, mental illness, coping potential, support system and willpower to overcome the disorder. It is been analysed that intellectual disorder patients coming from Urban cities have better coping capacity as compared to patients of rural areas due to their lack of care facilities, special schools, employment options, advocacy and many more measures that help to cure disorders. The care provisions of EHC plan, community care services and cognitive remediation helps to overcome this cultural difference in patients (Shaw et al. 2010). There also exist the impact of gender difference on patients of schizophrenia and intellectual disorder. It is been estimated that men’s age of Schizophrenia development is 15 to 25 years and that of women is 25 to 35 years. Similarly, Intellectual disorder is more common in men than women population of UK as well as other countries (Tandon et al. 2010). Heslop et al. (2014) studied that there is more concentration paid to cure the youth sufferers of mental disorder when compared to elder patients because they have the scope for improvement. The care standards provided to the elder crowd are very low in health care system. However, to overcome these issues, there are Proper standards for hospital and community care been developed that also involves training of professionals to meet the care requirements of the patient.   Demonstrating Knowledge And Understanding Of Effective Care Provision For Disabled People With Mental Health Problems The below described are some of the most successful care provision established in the United Kingdom as well as international level to meet the care needs of patients suffering from schizophrenia and intellectual disability. Advocacy The advocacy care services are support services to vulnerable of society helping them to access knowledge, gather education, explore options, make decisions, communicate effectively, develop self-esteem and protect their rights & responsibilities. The person enrolled in advocacy should not be a family member, friend, social workers or NHS professional (Heyman et al. 2010). The BILD is British Institute of Learning Disabilities provides advocacy services to sufferers of learning disabilities as well as their families to understand the disease. They empower the patient to explore choices and make self-decisions. Similarly, the BCSS is British Columbia Schizophrenia Society provides various care services along with advocacy on different regions of United Kingdom as well as Canada for sufferers of schizophrenia. Advocacy service development protocols have to follow the guidelines of Mental Health Act, Care Act 2014 and Community Treatment Order developed for patients with the mental disorder (Highland, N.H.S., 2010). Community Support Services And Standards For Clinical Care One of the most important care provision developed by Dual Diagnosis of Mental Health & learning Disability Policy by NHS is community care services that involve ‘social care’ for people with learning disabilities and Schizophrenia. These social care services are developed for adult and elder suffering from this mental disorder to deliver support practices that help patient to communicate properly, develop a social network, build relations and overcome their cognitive dysfunctions (Kreyenbuhl et al. 2010). As per Health and Social Care Act 2012, the NHS establishes community care service standards along with procedures for the regular monitoring of these protocols been followed in the care centre. These standard services involve improvement in funding arrangements for local community services, the better law supporting rights of schizophrenia people and better quality standards in the care centre. Some of the most effective community support services are the vision to individual care, family encouragement, personal budgets for patients, trained professionally as service providers, the establishment of social care criteria and better quality of clinical services (Werner and Stawski, 2012). There are various transformations made in Standards of Clinical Care by NHS to improve the care services of patients suffering for learning disabilities and other mental disorder. The inpatient treatment services are improved by standards like admitting special mental health care staff, raising funds for special cases, clinical psychologist, the psychiatrist in hospitals, update personal care plan, formal review collection and transforming care quality services. Psychological Interventions Psychological interventions for treatment of intellectual disabilities The psychological interventions are innovative changes in treatment practices for improving the treatment of the patient. The most effective psychological interventions in the treatment of intellectual disabilities is engaging professionals having skills to deliver behavioural interventions involved in Cognitive Behavioural Therapy (CBT) and Psychodynamic Therapy. The CBT involves interventions in talking and communication process to improve the treatment of intellectual disability patients. However, the CBT has certain limitations while working with patients having communication difficulties. Another behavioural intervention is the Psychodynamic therapy that helps to resolve the inner unconscious content of patient that helps to improve the low self-esteem of the patient. Psychological interventions for treatment of Schizophrenia The psychological intervention for schizophrenia involves Individual and Group Psychotherapies along with Psychological Skill Training to professionals. The individual psychotherapy involves the one-to-one interaction of patient and therapist. In contrast, the group psychotherapy is gathering of therapist for some therapeutic objectives. The psychological skill training involves the development of professionalism on the basis of Social learning Theories to analyse the complex behaviour schizophrenia. The training is provided for skill specification, modelling, leadership, didactic, verbal reinforcement and generalization (Pharoah et al. 2010).   Reviewing Care Provision For Disabled People With Mental Health Problems The above-described care provision are advocacy, community support services, improvement in clinical care standards and psychological interventions that are working in different manners to meet the necessities of people suffering from intellectual disabilities and schizophrenia. These care provision are the most successful once providing better health care services specifically to these communities. The community care practice of providing adult social care to people with learning disabilities is highly appreciated in England. Jones et al. (2012) opine that according to NHS Information Centre, out of £16.8 fund send by English council in 2010 for social care services, a minimum of 24% was spend in social care of adults with intellectual disabilities.  Heyman et al. (2010) indicated that for quality standard improvements the NHS funded £557 to improve the care of people suffering from intellectual disabilities for 58 NHS hospitals and 49 solo hospitals. The implementations of care standards have delivered high-quality care and support services, better hospital facilities, improved personal care plans and better-developed treatment options. The acute liaison nurses and professional in care standards providing exceptional advice and support to intellectually disabled people, families and other staff are considered as best practice in the improvement of health care standards by NHS (Care Quality Commission, 2012). As per Public Health England Department now the practices of establishing advisory groups in health care system is been forwarded due to the successful practice of advocacy. This advisory group in the organization are self-advocates and carers that work for a particular organization to provide advocacy services for patients (Emerson, 2012). The psychological interventions show effectiveness, however, Pharoah et al. (2010) studied that these interventions have certain limitations like cognitive behavioural therapy for schizophrenia patients suffering from speech defect gets limited because communication can’t be processed in therapy due to these speech defects of the patient. The psychodynamic therapy is effective but lacks trust building because they are innovative intervention procedures that require analysis. Chadwick et al (2012) indicated that psychodynamic interventions for disability patients have certain methodological faults that are require revising for better service delivery. Lawrence & Kisely (2010) studied that cognitive behavioural therapy is a common intervention used to cure many mental disorder. Therefore, taking it as a solo intervention for intellectual disabilities can create the development of confusion in care specialist to perform and follow protocol. These were the particular pros and cons of these care provisions to cure schizophrenia and intellectual disabilities.   Conclusion The mental care services of advocacy, community services and standards of clinical care delivery provides justification to health care needs of schizophrenia and intellectual patients practically by improving hospital care services, better education to patients, family engagement in treatment, social care development and mental support services. However, the psychological interventions of cognitive behavioural therapy fulfill the theoretical criteria established by Cognitive theory of mental status but is not considered as individual service for schizophrenia and intellectual disabilities. Along with this the psychodynamic therapy lacks the practical application outcomes, as this is the most innovative treatment process till date. This study helped the learner to understand the specific care requirements of people suffering from schizophrenia and intellectual disability. There is very less knowledge about the care needs required by people suffering from these mental disorder because these needs are bit complex to understand by manual diagnosis measures. But this study helped to elaborate these specific care needs and the care provision developed till today to overcome these care requirements. However, the lags of care provision indicate that still there is the requirement to revise these processes and implement better care options for schizophrenia and intellectual disabilities.   References Books Care Quality Commission, (2012). The state of health care and adult social care in England in 2011/12 (Vol. 763). London: The Stationery Office. Emerson, E., (2012). Clinical psychology and people with intellectual disabilities (Vol. 97). New Jersey: John Wiley & Sons. Glasby, J., (2012). Understanding health and social care. Bristol: Policy Press. Heyman, B., Alaszewski, A. and Shaw, M., (2010). Risk, safety and clinical practice: health care through the lens of risk. Cambridge: Oxford University Press. Johnstone, D., (2012). An introduction to disability studies. London: Routledge. Kisner, C. and Colby, L.A., (2012). Therapeutic exercise: foundations and techniques. Philadelphia: Fa Davis. Journals Chadwick, A., Street, C., McAndrew, S., and Deacon, M. (2012). Minding our own bodies: Reviewing the literature regarding the perceptions of service users diagnosed with serious mental illness on barriers to accessing physical health care. International Journal of Mental Health Nursing, 21(3), pp. 211-219. Heslop, P., Blair, P.S., Fleming, P., Hoghton, M., Marriott, A. and Russ, L., (2014). The Confidential Inquiry into premature deaths of people with intellectual disabilities in the UK: a population-based study. The Lancet, 383 (9920), pp.889-895. Highland, N.H.S., (2010). Clinical Governance & Risk Management: Achieving safe, effective, patient-focused care and services. Jones, L., Bellis, M.A., Wood, S., Hughes, K., McCoy, E., Eckley, L., Bates, G., Mikton, C., Shakespeare, T. and Officer, A., (2012). Prevalence and risk of violence against children with disabilities: a systematic review and meta-analysis of observational studies. The Lancet, 380(9845), pp.899-907. Kreyenbuhl, J., Buchanan, R.W., Dickerson, F.B. and Dixon, L.B., (2010) The schizophrenia patient outcomes research team (PORT): updated treatment recommendations 2009. Schizophrenia bulletin, 36(1), pp.94-103. Lawrence, D., & Kisely, S. (2010). Review: Inequalities in healthcare provision for people with severe mental illness. Journal of psychopharmacology, 24(4), pp. 61-68. Pharoah, F., Mari, J., Rathbone, J., and Wong, W. (2010). Family intervention for schizophrenia. Cochrane Database Syst Rev, 2 (9), pp. 12. Shaw, K.L., Clifford, C., Thomas, K. and Meehan, H., (2010) Improving end-of-life care: a critical review of the Gold Standards Framework in primary care. Palliative Medicine, 3(5), pp.45. Stylianos, S. and Kehyayan, V. (2012). Advocacy: critical component in a comprehensive mental health system. American Journal of Orthopsychiatry, 82(1), pp. 115-120. Tandon, R., Nasrallah, H.A. and Keshavan, M.S., (2010). Schizophrenia “Just the Facts” 5- Treatment and prevention Past, present, and future. Schizophrenia research, 122(1), pp.1-23. Tsang, H. W. H., Fung, K. M. T., and Chung, R. C. K. (2010). Self-stigma and stages of change as predictors of treatment adherence of individuals with schizophrenia. Psychiatry Research, 180(1), pp.10-15. Werner, S. and Stawski, M., (2012). Mental health: knowledge, attitudes and training of professionals on dual diagnosis of intellectual disability and psychiatric disorder. Journal of Intellectual Disability Research, 56(3), pp.291-304. Wiese, M., Stancliffe, R.J., Balandin, S., Howarth, G. and Dew, A., (2012). End‐of‐life care and dying: issues raised by staff supporting older people with intellectual disability in community living services. Journal of Applied Research in Intellectual Disabilities, 25(6), pp.571-583.

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