Excerpt

The guideline makes recommendations for the prevention, identification, assessment and management of mental health problems in people with learning disabilities. It aims to:

• improve access and engagement with treatment and services for people with learning disabilities
• evaluate the role of specific physical, psychological, psychosocial and pharmacological interventions (and any combination of the above) in the treatment of mental health problems in people with learning disabilities
• integrate the above to provide best-practice advice on the care of individuals throughout the course of their treatment
• promote the implementation of best clinical practice through the development of recommendations tailored to the requirements of the NHS in England and Wales.

Contents

• Guideline Committee members and National Collaborating Centre for Mental Health review team
• Acknowledgments
• 1. Preface
  • 1.1. National clinical guidelines
  • 1.2. The national mental health problems in people with learning disabilities guideline
• 2. Introduction
  • 2.1. Definitions and terminology
  • 2.2. Prevalence
  • 2.3. Incidence and temporal patterns
  • 2.4. Co-morbidities
  • 2.5. Associated characteristics and causes
  • 2.6. Current care
  • 2.7. Family
  • 2.8. Economic costs
• 3. Methods used to develop this guideline
  • 3.1. Overview
  • 3.2. The scope
  • 3.3. The Guideline Committee
  • 3.4. Review protocols
  • 3.5. Clinical review methods
  • 3.6. Health economics methods
  • 3.7. From evidence to recommendations
  • 3.8. Stakeholder contributions
  • 3.9. Validation of the guideline
• 4. Identification and assessment of mental health problems
  • 4.1. Introduction
  • 4.2. Review question 1.1
  • 4.3. Review question 1.2
  • 4.4. Recommendations and link to evidence
  • 4.5. Review question 1.3
  • 4.6. Recommendations and link to evidence
• 5. Psychological interventions
  • 5.1. Introduction
  • 5.2. Review questions 2.1 and 3.1
  • 5.3. Review question 2.12
• 6. Pharmacological interventions
  • 6.1. Introduction
  • 6.2. Review questions 2.4 and 3.4
  • 6.3. Recommendations and link to evidence
• 7. Other interventions
  • 7.1. Introduction
  • 7.2. Review question 2.11
  • 7.3. Review questions 2.5 and 3.5
  • 7.4. Review questions 2.13 and 3.11
  • 7.5. Recommendations and link to evidence
  • 7.6. Review questions 2.2 and 3.2
  • 7.7. Clinical evidence and group consensus
  • 7.8. Review questions 2.8 and 3.8
  • 7.9. Review questions 2.3 and 3.3
  • 7.10. Review questions 2.9 and 3.9
  • 7.11. Review questions 2.10 and 3.10
  • 7.12. Review questions 2.6 and 3.6
  • 7.13. Review questions 2.7 and 3.7
• 8. Organisation and service delivery
  • 8.1. Introduction
  • 8.2. Review question 4.5
  • 8.3. Review question 4.4
  • 8.4. Review question 4.6
  • 8.5. Review question 4.1
  • 8.6. Review question 4.2
  • 8.7. Review question 4.3
  • 8.8. Recommendations and link to evidence
• 9. Family carer and staff interventions
  • 9.1. Introduction
  • 9.2. Review question 5.1
  • 9.3. Recommendations and link to evidence
• 10. Summary of Recommendations
  • 10.1. Using this guideline with other NICE guidelines
  • 10.2. Organisation and delivery of care and support
  • 10.3. Involving people with learning disabilities, and their family members, carers or care workers, in mental health assessment and treatment
  • 10.4. Support and interventions for family members and carers
  • 10.5. Social and physical environment interventions
  • 10.6. Annual health check
  • 10.7. Identification and referral
  • 10.8. Assessment
  • 10.9. Psychological interventions
  • 10.10. Pharmacological interventions
  • 10.11. Occupational interventions
• 11. Abbreviations
• 12. References
• Appendices
  • Appendix A. Scope for the development of the clinical guideline
  • Appendix B. Declarations of interests by Guideline Committee members
  • Appendix C. Special advisors to the Guideline Committee
  • Appendix D. Stakeholders who submitted comments in response to the consultation draft of the guideline
  • Appendix E. Researchers contacted to request information about unpublished or soon-to-be published studies
  • Appendix F. Review questions and final review protocols
  • Appendix G. High-priority research recommendations
  • Appendix H. Search strategies for the identification of clinical studies
  • Appendix I. Search strategies for the identification of health economic studies
  • Appendix J. Clinical evidence – study characteristics, outcomes, methodology checklists and excluded evidence for all case identification studies
  • Appendix K. Clinical evidence – study characteristics, outcomes, methodology checklists and excluded evidence for all assessment studies
  • Appendix L. Clinical evidence – study characteristics, outcomes, methodology checklists, for all intervention studies
  • Appendix M. Clinical evidence – study characteristics, outcomes, methodology checklists and excluded evidence for organisation and service delivery studies
  • Appendix N. GRADE evidence profiles for all studies
  • Appendix O. Clinical evidence – forest plots for all studies
  • Appendix P. Clinical and economic evidence - flow diagrams
  • Appendix Q. Health economic evidence – completed checklists
  • Appendix R. Health economic evidence – evidence tables
  • Appendix S. Health economic evidence – economic profiles
  • Appendix T. Nominal group technique questionnaires
  • Appendix U. Results from nominal group technique
  • Appendix V. BILD service user focus group report
  • Appendix W. Clinical evidence – study characteristics, outcomes, methodology checklists, for additional carer wellbeing studies

This guideline was developed by the National Guideline Alliance, hosted by the Royal College of Obstetricians and Gynaecologists

Disclaimer: The recommendations in this guideline represent the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, professionals are expected to take this guideline fully into account, alongside the individual needs, preferences and values of their patients or service users. The recommendations in this guideline are not mandatory and the guideline does not override the responsibility of healthcare professionals to make decisions appropriate to the circumstances of the individual patient, in consultation with the patient and/or their carer or guardian.

Local commissioners and/or providers have a responsibility to enable the guideline to be applied when individual health professionals and their patients or service users wish to use it. They should do so in the context of local and national priorities for funding and developing services, and in light of their duties to have due regard to the need to eliminate unlawful discrimination, to advance equality of opportunity and to reduce health inequalities. Nothing in this guideline should be interpreted in a way that would be inconsistent with compliance with those duties.

NICE guidelines cover health and care in England. Decisions on how they apply in other UK countries are made by ministers in the Welsh Government, Scottish Government, and Northern Ireland Executive. All NICE guidance is subject to regular review and may be updated or withdrawn.