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Hamad Medical Corporation’s (HMC) Mental Health Service (MHS) has introduced a new Learning Disability Service (LDS) to provide specialist assessment and treatment options for adults with a Learning Disability (LD) presenting with a mental health condition, who exhibit severely challenging behaviour.
The specialist LDS was piloted in early 2020 but due to COVID-19 restrictions regarding patient visits the service was enhanced in December 2020. The service has now been formally launched to support the expansion in mental health service provisions, with a new multidisciplinary team offering outpatients clinics, community outreach services and consultation liaison services with other health service provisions.
Dr Majid Al Abdullah, chair of Psychiatry and medical director of MHS, explained that challenging behaviour may be an indicator of physical ill health in people with a learning disability.
“These behaviours can include irritable temper outbursts, hitting or kicking other people or throwing things. It can be any type of behaviour that might be harmful to the persons and others around them, and stops them from achieving things in their daily life, such as making friends or concentrating on a school or work project,” said Dr Abdullah.
He added, “Learning disabilities often encompass communication difficulties and this may contribute to frustration that is exhibited in various challenging behaviours. In people with more severe learning disabilities, the behaviours may be a form of communication with others and it is important that every effort is made by family, friends and carers to understand that the individual needs help to communicate and manage their emotions.
“Such behaviours often start in childhood and can become more pronounced in time if left untreated. Modern behavioural therapies and techniques have been found to be very effective in many cases, allowing families to cope much better with the disability.”
The service caters for male or female adults aged 18 and above with all levels of severity of learning disabilities who have associated mental health conditions along with behaviours that can be challenging for the individuals and the people around them.
Iain Tulley, national lead for Mental Health and Wellbeing and CEO of the MHS, said, “Our goal is to provide families with appropriate strategies and effective support in managing their loved one’s severely challenging behaviour, which can be very stressful for all concerned.
“The overarching aim is to reduce unnecessary inpatient admissions of patients with LD and mental health conditions by providing services within their own environment. We are planning to expand the service with specialist inpatient provision in phases in future as part of the service development.”
Dr Mohamed El Tahir, senior consultant psychiatrist at the MHS and LDS lead, explained that that the multi-disciplinary team includes experts who can cover a wide range of cases, both within the hospital system and in the community.
He said, “We see adults with a learning disability who may not have had a proper diagnosis or treatment previously but where their behaviour has deteriorated to such an extent that clinical intervention was required. We also care for patients with behavioural problems related to neuro-developmental disorders or cognitive deterioration leading to dementia.”
“Each case is carefully reviewed and care plans developed collaboratively with the healthcare team and the family concerned. Where possible, we will work towards promoting recovery and rehabilitation for patients with LD and assist them in achieving their full potential, this includes facilitating a safe discharge from inpatient care when needed and enabling them to live as comfortable life as possible,” added Dr El Tahir.
The LDS receives referrals from Primary Health Care, Hamad Hospital departments and internal referrals from MHS. The team triage referrals on weekly basis and arrange to see them within appropriate environment and time using standardised models of care and prioritisation.
Patients admitted to HMC facilities are seen as a consultation liaison service with their care teams.
LDS also offers education, training and support for families, carers and staff working with LD people with challenging behaviours to build competency in care and improve individual’s quality of life.
Where necessary, the LDS team can act as advocates for the person with LD to ensure their ethical and legal rights are safeguarded.
Learning disability (also known as ‘intellectual developmental disorder’ or ‘intellectual disability’) is a lifelong condition that manifests during the early childhood and is characterised by deficits in both intellectual and adaptive functioning.
Challenging behaviour considered to be inconsistent with cultural norms is often defined as ‘behaviour(s) of such intensity, frequency or duration that the physical safety of the person or others is placed in serious jeopardy, or behaviour which is likely to seriously limit or deny access to the use of ordinary community facilities’.
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21/01/2021
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