Adults with learning disability admitted to psychiatric wards

Robert Chaplin is a consultant in general adult psychiatry who works with an inner-London community mental health team (Tooting & Furzedown CMHT, Springfield Hospital, 61 Glenburnie Road, London SW17 OJB; tel/fax: 0181 682 6439) and Honorary Senior Lecturer at St George’s Hospital Medical School. He has received training in learning disability at Registrar and Senior Registrar levels including a special interest session while working in Australia. Andrew Flynn is a specialist registrar in the psychiatry of learning disability. His special interests include the assertive community management of mental illness and severe challenging behaviour in adults with learning disability. People with learning disability have an increased risk of developing a mental disorder. When they need acute psychiatric hospitalisation, they are frequently admitted to general psychiatric beds under the care of general adult psychiatrists, many of whom have had little training in the assessment and treatment of mental illness in this group. They may have unusual presentations of common mental disorders leading to difficulty in diagnosis and idiosyncratic responses to treatment. Boundary disputes between general adult and learning disability services frequently lead to a reduced quality of care for people with complex needs (see Bernal & Hollins (1995) for an overview of psychiatric illness and learning disability). This paper will focus on the issues specific to the management of people with learning disability on general psychiatric wards, and is aimed at psychiatrists working in both general psychiatry and learning disability.