What do we mean by ‘Intellectual disability’?
A disorder characterized by significant limitations in both intellectual functioning and adaptive behaviour, originating before age 18.
What are the four sub-average intellectual functioning IQ levels?
Mild (IQ 50–70), Moderate (IQ 35–49), Severe (IQ 20–34), Profound (IQ <20).
Is it all about the person’s IQ? What else is measured in intellectual disability?
No.
Adaptive functioning: communication, social skills, daily living skills, independence.
Why do people with ID have higher rates of mental illness?
Increased vulnerability to stress and environmental changes, social exclusion and lack of supportive networks, communication difficulties limiting coping strategies, increased risk of trauma, abuse, or neglect, biological and neurological comorbidities.
Can people be placed under the MHA92 solely due to an intellectual disability?
No.
When can compulsory assessment and treatment be applied under MHA92?
If a co-existing mental disorder is present that meets criteria (e.g., psychosis, severe depression), following legal and ethical safeguards.
What are communication factors for assessment?
Use simple, clear language and avoid jargon, consider non-verbal communication cues, allow extra time for responses, confirm understanding and use repetition or visual aids.
Who should be included in the assessment?
Family / caregivers, multidisciplinary team (MDT) including psychologist, psychiatrist, social worker, speech-language therapist, support workers familiar with the individual.
What are the JOMAAC assessment categories?
Judgement: Ability to make decisions and solve problems, Orientation: Awareness of time, place, and person, Memory: Short-term and long-term recall, Affect: Emotional state and stability, Attitude: Cooperation, insight, and engagement, Cognition: Thinking processes, attention, reasoning.
What is diagnostic overshadowing?
When physical or mental health symptoms are misattributed to the intellectual disability, leading to underdiagnosis or delayed treatment.
What are the implications for care regarding diagnostic overshadowing?
Risk of missing treatable conditions, may result in inadequate treatment or neglect, need for thorough assessment and individualized care plans.
What are key concerns / nursing diagnoses for Sophie?
Psychosis: hallucinations, delusions; Aggression / self-harm (head hitting); Social withdrawal / decreased engagement; Poor hygiene and self-care; Anxiety / fear of parents.
What are potential stigma and discrimination issues for Sophie?
Being dismissed as ‘just part of her intellectual disability’, negative assumptions about behaviour, risk of isolation from family and peers, stereotyping and reduced opportunities for participation.
What are the rights of Sophie?
Right to dignity, respect, and humane treatment; right to informed consent and participation in care planning; right to be free from discrimination and stigma; right to advocacy and support in decision-making.
What is the discharge / support plan rationale & aims for Sophie?
Ensure Sophie’s mental health stability, maintain safety, support family in care, reduce distress.
What are the signs & symptoms of psychosis for Sophie?
Hallucinations, delusions, withdrawal, aggression, poor hygiene.
What are triggers / things that don’t help Sophie?
Overcrowding, stress, unexpected changes, lack of familiar support.
What are the prevention strategies for Sophie?
Structured routine, consistent support staff, clear communication, family education, calming strategies.
What is the crisis management plan for Sophie?
Immediate safety interventions, de-escalation techniques, access to mental health team, rapid assessment for acute changes.
