Introduction

Life in the community for individuals with intellectual disabilities (ID) implies new roles and responsibilities for professionals providing mental health care to this population. A diverse range of mental health service models have emerged both nationally and internationally to meet these needs. In some cases, emphasis is on the provision of generic mainstream services to individuals with ID, while in others specialist services have been developed, either working independently of or in tandem with generic teams. This variability implies that a variety of professional groups require specialist knowledge for assessing, treating and managing mental health problems in individuals with ID. Very little is written about the education of professionals providing mental health care for this group and there is a lack of recognition of the need for formalized training in mental health and ID from a national and international perspective. Many training programmes appear ad hoc, with the availability and content of most educational initiatives being largely determined by the specific interests of those individuals providing and undergoing training. This chapter reviews the training programmes of three groups of health care professionals (psychiatrists, psychologists and primary care physicians) available in five countries (UK, USA, Canada, Australia and Austria) in relation to mental health problems in individuals with ID. The role of specific institutions and key individuals in increasing the profile of mental health problems in this population is highlighted, factors hindering the development of professional training are identified and recent innovations in curricula are described.

People with intellectual disabilities and mental health problems have the same right to high standards of assessment, treatment, and as good a quality of life as other people. Historically, the mental health problems of people with intellectual disabilities have had a low priority in health care systems around the world. Consequently the treatment facilities have been insufficient, the training of staff underdeveloped and the care offered far from the best to meet their mental health needs. This is further compounded by the fact that the mental health problems of people with intellectual disabilities are often very complex, difficult to diagnose and require specialist multiprofessional involvement.

The potential for comprehensive and effective care of people with intellectual disabilities and mental health problems has improved greatly in recent years with developments in the way that people with disabilities are viewed within society, increased understanding of psychological processes and with advances in neuroscience, genetics and neuro imaging. There are now more effective treatment methods including behaviour therapy, psychopharmacology, psychosocial interventions and psychotherapy.

This second edition of the book Psychiatric and Behavioural Disorders in Developmental Disabilities and Mental Retardation is fully revised and offers an up-to-date account in the field. In this edition we have replaced the term ‘mental retardation’ with ‘intellectual disabilities’ as the latter has gained widespread international recognition and acceptance.