People With Intellectual Disabilities and Complex Needs - Essay Example

People With Intellectual Disabilities and Complex Needs: A Critical Analyzing People With Intellectual Disabilities and Complex Needs: A Critical Analyzing In regards to the subject of the concept of health in relation to children, young people and adults with intellectual disabilities and complex needs, there is a great deal that must be dealt with and taken seriously into consideration. This issue as a whole is one of such great premise and detail, and in all its complexity it thus must be understood by thoroughly looking at and examining all of the necessary aspects, and there are many. Despite a growing body of research into this matter overall, there are still many basic questions that remain and which surround it, and these questions must be answered logically and purposefully as well in order to be able to gain a proper grasp on this topic. In order to come to an even remotely knowledgeable understanding on this matter, all of this must be discussed and taken seriously into consideration, and only by doing this will we be able to come to properly and critically analyze this topic overall. This is what will be dissertated in the following. One of the first things that needs to be known here is that the life expectancy of a person with an intellectual disability is approximately twenty years lower than that of the general population (Bittles et al, 2002), and not only that, but as well, obesity for people with intellectual disabilities is up to three times the level in the general population. There are reasons for this however, and this situation actually arises directly from a wide range of factors, including that of the following: communication issues between professional and patient, capacity to communicate, and the training in regards to communication techniques; people with intellectual disabilities are particularly vulnerable to various different and not necessarily specific health conditions; health professionals need to spend more time with people that have intellectual disabilities in order to allow them to gain better life structure and this includes everything from speech pattern and language to physical behavior and well-being; inadequate supply of free and subsidized health services, for example dental care; and as well, disability services have rightly moved away from that of a 'medical motel' but without the proper systems having been established in order to ensure appropriate and proper health care. Children's perceptions concerning health-related actions exchanged with parents, siblings, and school personnel were studied. Five- to twelve-year-olds (n = 1,674) reported receiving and initiating health actions related mainly to the promotion of healthy lifestyle behaviors, but promotion of harmonious interpersonal relationships, helping behaviors, and therapeutic acts also occur Results show that children do not see themselves solely as receiving health care and advice from others, but also as acting upon others' health. The findings provide information about children's perceptions of bidirectional health-related actions between themselves and others; aspects of health cognitions and health socialization that have received little attention and that are of interest from a primary prevention perspective. Furthermore, in 1982, a Cross-National Survey on Health Behaviours in School-Aged Children (HBSC) was initiated by researchers from three countries: England , Finland , and Norway . Shortly thereafter, the project was adopted by thes World Health Organization (WHO) Regional Office for Europe as a WHO Collaborative study. Between 1983/84 and 1989/90 three more surveys were conducted and the number of participants climbed to 16 countries, including Canada . HBSC surveys are now administered every four years. Currently, Canada has participated in the 1989/90, 1993/94, 1997/98 and 2001/02 survey cycles and the number of participating countries has climbed to 35. A major goal of this international approach is to influence health promotion and health education policies and programs in schools and among young people in general. Data is collected through surveys among 11, 13 and 15 year olds. All participating countries use a common methodology and pool their data to form the cross-national data file. By analysing trends over time, it is will be possible to show changes in health behaviours in a particular country can be followed. (Public Health Agency of Canada, 2007). There are many organizations that are presently working towards the realizing and then mending of any types of children and young people's health systems and thus they will be changing the overall concept of health in regards to both children and young people alike, and this will greatly alter the measurement of the quality of life in regards to both these groups, as the concept of health in relation to them overall will be looked at incredibly differently, and thus will be dealt with more positively and with better overall results then as well. In order to understand the basic framework surrounding this agenda, one must first understand the conceptual framework; basically, the HBSC studies that have been done are deeply rooted into that of the social and economical sciences, and however they have not yet been restricted to the concepts and frameworks of any one theoretical model, which is obviously an incredibly positive thing, as then changes can be made in regards to various different angles, in order to make things better overall. Nevertheless, a common conceptual framework for the development of the HBSC study has been adopted, and this has been termed "the socialization perspective" in which the influence of various "areas", such as school, family, friends, and so on, on children and young people's health and health related behaviors are then systematically explored. (Public Health Agency of Canada, 2007). In regards to children, young people, and adults with intellectual disabilities and complex needs, there are quite obviously various different problems that are present in regards to the health care that is being given, and thus to the quality of life that is being offered, and so thus there has been the need for some strategies for action to arise, so that any problems or dilemmas can be fixed and so that thus the measurement of the quality of life for these groups of people can be greatly and thus satisfactory improved. There are many strategies for action that are presently in place, and this includes that of the following: national acknowledgement of people with intellectual disabilities as a particularly disadvantaged group, rather than simply including them as part of the general population; adopting certain and specific health guidelines for people with these intellectual disabilities such as those of the International Association for the Scientific Study of Intellectual Disability; and the health system otherwise encouraging health professionals to spend time needed to treat a person with an intellectual disability and encouraging a multidisciplinary approach. (CID, 2006). Furthermore, it should be made sure that there is enhanced provision of free dental services, as the number of free services to these groups of people are presently staggeringly low; as well there should be the assurance that all health professionals receive certain values based training in regards to the issues of communicating with and treating people with disabilities; and as well, it should be ensured that all health planning includes a focus on those people who have intellectual disabilities, including that of consultation with people with disabilities, and with their families and other advocates in relation to this as well. It is thought that there really are no simple solution for people with intellectual or complex needs, regardless of their age, and this is why the problem has remained as a problem for so long now; basically, in order to move forward, one must realize that getting it right in regards to mental illness reform means that we need to create a system that truly meets all of the needs of all of those people who have intellectual and/or complex needs, and people with a psychiatric condition plus an intellectual disability for instance suffer the greatest unmet need, and once this is taken fully and seriously into consideration, we can realize and truly understand the great need for an improvement in areas of health in regards to these people. However we should also make note of the fact that there really has been great improvement in regards to this issue if we look at the problems today compared to those of even a couple decades ago; services for those people with intellectual disabilities and complex needs have been greatly transformed since the late 1900s, especially starting from around the 1960s timeframe and on, by the move from institutional to community care. What this basically means is that not too long ago, people with intellectual disabilities and complex needs were kept in improper environments, such as institutions, whereas now they are being treated properly and sanely in more community-style living spaces. This is incredibly positive in regards to a change in this matter, as the community living for these people creates an instantly more accepting and understanding environment for these people, and this is incredibly important in regards to their quality of life overall. Advocates of normalisation support the mainstream approach, arguing that specialised services lead to stigmatisation, labelling and negative professional attitudes. Others have demonstrated that special expertise is required for the diagnosis and treatment of psychiatric disorders in this population. They have argued for specialist mental health teams, pointing out that although it is theoretically possible to train staff in mainstream settings, the small number of cases gives little opportunity for staff in the various disciplines to gain the necessary skills. Additionally, mainstream staff often feel that such care is not part of their role, and the resources of adult mental health services are already stretched (Day, 1988). Problems arise particularly over admissions to adult acute in-patient units, as people with learning disabilities often require a longer stay and may be vulnerable without additional support on the ward. Furthermore, people with learning disabilities represent a heterogeneous group with a varied range of complex mental health needs, which mainstream staff may feel ill-equipped to meet. Service responses have as a result varied both nationally and internationally. They include provision from mainstream mental health care services, including in-patient admissions; a specialist mental health service for people with learning disabilities provided as part of the mainstream mental health service, with specialist in-patient beds; and a specialist learning disabilities service, with several functions (such as skill development and needs assessment, including mental health care), with or without inpatient beds (Bouras & Jacobson, 2002). Overall, it is quite easy now that we have thoroughly analyzed the concept of health in relation to children, young people, and adults with intellectual disabilities and complex needs, that although many changes have been made over time, and regardless of the fact that their measurement of quality of life is now much higher than it has ever been, there are still a large number of improvements that have to be made, and as well, the current evidence base for the organisation and delivery of mental health care for people with learning disabilities is inconclusive and inconsistent. It relies largely on retrospective reports and uncontrolled studies with small numbers of participants. However it is also incredibly important to realize that there are a handful of randomized controlled trials. A Dutch study showed a reduction in hospitalization from a service provided by a community learning disability team; furthermore, intensive case management provided in a special program by a mainstream community mental health team in the USA improved adaptive functioning in a group of people with learning disabilities and psychiatric disorders. In both studies the sample size was small. A subgroup of people with borderline cognitive impairment in the UK700 study were found to have spent significantly less time in hospital if they had received intensive community care. This was an unintentional finding, as the study was not designed for a population with learning disabilities. Thus, truly the overall quality of life of these groups of people needs to be again thoroughly looked at and examined, and only after this will we be able to come to a proper and understanding acknowledgement in regards to this matter as a whole. References Australian Law Reform Commission. (n.d.). Children, Young People, and Adults With a Decision-Making Disability. Retrieved January 8, 2007, from http://www.austlii.edu.au/au/other/alrc/publications/issues/31/9.html Beange, H., McElduff, A., Baker, W. (1995). Medical Disorders of Adults With Mental Retardation: A Population Study. AJMR 99: 595. Bittles, A. H., et al. (2002). The Influence of Intellectual Disability on Life Expectancy. J Gerontol A Biol Sci Med Sci 57:7; M470-M472. Bouras, N., & Jacobson, J. (2002). Mental Health Care for People With Mental Retardation: A Global Perspective. World Psychiatry. 1: 162-165. CID. (2006). Health and People With Intellectual Disability. Retrieved January 8, 2007, from http://www.nswcid.org.au/systemic/position/health.html Community Services Commission. (2001). Disability, Death and the Responsibility of Care (A Review of the Characteristics and Circumstances of 211 People With Disabilities who Died in Care Between 1991 and 1998 in NSW). Day, K. (1998). Services for Psychiatrically Disordered Mentally Handicapped Adults. Australia and New Zealand Journal of Developmental Disabilities, 14: 19-25. Department of Health UK. (2001). Valuing People: A New Strategy for Learning Disability for the 21st Century Chapter 6: "Improving Health for People With Learning Disabilities". International Association for the Scientific Study of Intellectual Disability. (2002). Health Guidelines for Adults with an Intellectual Disability. Retrieved January 8, 2007, from http://www.iassid.org/pdf/healthguidelines-2002.pdf Lennox, N. (2002). Issues Paper - National Health Priority Targets for Adults With Developmental Disability Developmental Disability Unit, Faculty of Health Sciences, University of Queensland. Onyango-Ouma, W., Aagaard-Hansen, J., & Jenson, B. B. (n.d.). Changing Concepts of Health and Illness Among Children of Primary School Age in Western Kenya. Retrieved January 8, 2007, from http://her.oxfordjournals.org/cgi/content/full/19/3/326 Public Health Agency of Canada. (2007). Health Behavior in School-Aged Children. Retrieved January 8, 2007, from http://www.phac-aspc.gc.ca/dca-dea/7-18yrs-ans/hbschealth_e.html Scott, A., Marsh, L, & Stokes, M. L. (1989). A Survey of Oral Health in a Population of Adults With Developmental Disability: Comparison With a National Oral Health Survey of the General Population. ADJ 43: 257-261. US Department of Health and Human Services. (2002). Closing the Gap: A National Blueprint to Improve the Health of Persons With Mental Retardation. Retrieved January 8, 2007, from http://www.surgeongeneral.gov/library/ Williams, S. J. (2003). Beliefs of Young People in Relation to Health, Risk and Lifestyles. Retrieved January 8, 2007, from http://www.dh.gov.uk/PolicyAndGuidance/ResearchAndDevelopment/ResearchAndDevelopmentAZ/MotherAndChildHealth/MotherAndChildHealthArticle/fs/enCONTENT_ID=4015169&chk=CfroCg Read More