Adults with Learning Disabilities and Mental Health Needs: Conceptual and Service Issues

This paper introduces service changes impacting on adults with learning disabilities, defines the concepts of learning disability, needs and need assessments, dual diagnosis and mental health needs and considers their service implications. Between 25% and 50% of adults with learning disabilities have mental health needs, and the main clinical types are outlined. The findings from a national multi‐professional survey of services for adults with learning disabilities and mental health needs are summarised and the difficulties of meeting the complex needs of these adults are demonstrated. Recent developments in clinical diagnostic assessment, needs assessment, care planning, outcome monitoring, staff training and service evaluation are discussed, including the possible advantages of the care programme approach (CPA). Recommendations are given for services for adults with learning disabilities and mental health needs and points for discussion with service users and carers are suggested.