Community services for people with intellectual disabilities and mental health problems.
OBJECTIVE
This review will examine the most recently published studies of community services for people with intellectual disabilities and mental health problems.


RESULTS
There is a continuing lack of evidence regarding these community-based services. Few studies have been published at all whilst even fewer still have reported outcomes in any detail. Recent studies have attempted to evaluate assertive community treatment for this service user group; however, they have been unsuccessful owing to inconsistency about what an assertive community treatment service should be for people with intellectual disabilities.


CONCLUSIONS
An evidence base is urgently needed for these community-based services. Research should utilize the opinions of service users and their carers as well as professionals and focus on those people with intellectual disabilities and more severe mental health problems. It may be more fruitful to examine the components of community-based services rather than use the terminology of specific models such as assertive community treatment. The service components considered to be essential need first to be identified using a systematic methodology and then evaluated using a broad range of outcomes.
Hemmings
Colin P
CP
Consultant Psychiatrist in Learning Disabilities, South London and Maudsley NHS Trust, London, UK. Colin.Hemmings@slam.nhs.uk
D000328:Adult; D000374:Aggression / Q000523:psychology; D003156:Community Mental Health Services; D003159:Community-Institutional Relations; D015897:Comorbidity; D003688:Deinstitutionalization; D019317:Evidence-Based Medicine; D006801:Humans; D008607:Intellectual Disability / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy*; D001523:Mental Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy*; D020380:Needs Assessment; D010348:Patient Care Team; D010359:Patient Readmission; D012559:Schizophrenia / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D016896:Treatment Outcome; D006113:United Kingdom