Mental health in people with learning disabilities

There are around 1 million people with learning disabilities in England and estimates of prevalence of mental health problems vary from 25-40%, depending on the population sampled and the definitions used.

Prevalence of anxiety and depression in people with learning disabilities is the same as the general population, yet for children and young people with a learning disability, the prevalence rate of a diagnosable psychiatric disorder is 36%, compared with 8% of those who do not have a learning disability.

People with learning disabilities and their families tell us that they do not get support to think or talk about mental health problems in the same way that they get increasingly with physical health. If a mental health problem presents, for whatever reason, it is more likely to be attributed to their learning disability (diagnostic overshadowing) or classed as challenging behaviour.

We often hear from staff in learning disability services that they are not informed about or encouraged to promote mental health, or to look out for early warning signs of common mental health problems. Worryingly, people with mild to moderate learning disabilities are also at particular risk of falling between the gap of learning disability services and mental health services, as there is often disagreement about which specialist should treat them, with both services denying that the individual meets eligibility criteria.

People persistently comment that access to the full range of mental health interventions for people with learning disabilities is limited and, furthermore, assumptions are often made that they will not benefit from such treatments as ‘talking therapies’, although research and guidance is available on the applicability of CBT and Mindfulness.

The Government’s ‘Valuing People Now’ and ‘No Health Without Mental Health’ policies identify that people with learning disabilities are at an increased risk of mental health problems and that services must address this need. Yet, despite the evidence on prevalence and on good practice, it seems that:

  • There is little attention to promoting mental health amongst people with learning disabilities, their families and frontline staff.
  • There is insufficient attention to identifying early warning signs of common mental health problems.
  • A minority of people with learning disabilities get an annual health check in primary care; of those who do, it is not known how well mental health issues are covered. If people with learning disabilities, their families and staff are not alert to mental health problems, this may affect the detection rate via health checks.
  • 'Boundary’ problems between secondary mental health and learning disability services persist.
  • We are now left asking the question – “what would make a difference”?