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Tijdschrift voor Psychiatrie 61 (2019) 6, 375 - 383


Modifications in therapy for patients with severe mental illness and intellectual disability: a qualitative study

I. Berger, M. van der Hout, A.M.C.H. Hoogenboom, E. Berger, C.L. Mulder

background In ambulant psychiatric care, intellectual disability (id) is often not recognised. Therefore, a Screener for Intelligence and Learning disabilities (scil) was recently introduced to assist recognition. However, because, current therapy is not adjusted for id-related problems, its effectiveness remains unknown.
aim To gain insight into adequate adaptation of interventions by professionals for patients with severe mental illness (smi) and id, to improve the quality of care without the need to develop a completely new program of therapy.
method A qualitative design (n=15) including 8 interviews and one focus group, among psychiatric practitioners and id experts.
results Five main themes were identified to adjust therapy: treatment, communication, inclusion of the network, estimation of support needs and self-management. conclusions To align therapy with the requirements of patients with smi and id, a patient-oriented approach to care is necessary. Simple but effective modifications, summarised in a toolkit, appear to contribute to this. To offer appropriate care to patients with smi and id, attention is needed for both a support-oriented and a recovery-oriented approach.

keywords intellectual disability, self-management, severe mental illness, support needs