Working together between IAPT and Learning Disability Services

This article briefly describes the successful partnership between our Mind Matters (IAPT) service and the Community Team for People with a Learning Disability (CTPLD) to deliver mainstream psychological therapies to people with learning disabilities.

In 2013, we were participants in an Action Learning Programme funded by the Department of Health and run by the Foundation for People with Learning Disabilities in partnership with Kings College London and The Cumbria NHS Foundation Trust. Its aim was to inform practitioners, commissioners and all involved in IAPT in making access to people with learning disabilities possible.  Each service that participated in the programme was asked to establish a reference group to guide the learning. 

Our multiagency / multidisciplinary reference group across CTPLD and IAPT services first met in October 2013.  We undertook mapping exercise of issues and identified the barriers to working together – these included issues re contracts; referral pathways; suitability of IAPT; lack of skills and knowledge.  We identified 2 IAPT and 2 LD staff to attend the Action Learning Programme over the two year period.

We identified that we needed to link with each other regularly; needed a commitment that IAPT services want to work with people with learning disabilities; clear Pathway/ criteria / guidelines; joint working and help with physical resources for IAPT e.g. Screening, Easy Read materials, Adapt therapeutic approaches / training both to / from IAPT.

Over the past 5 years we have worked together to deliver two types of work.  Firstly, individual work in IAPT with people with LD, with support from CTPLD as required – this can be Step 2 or Step 3, or Step 3+.  Secondly, the development and continued refinement of wellbeing groups for people with LD jointly with IAPT.  These are at Level 2 as these are the most cost effective.  The 4 week groups are run in settings which people with LD attend e.g. local colleges –  and were co-developed between people with LD, IAPT and CTPLD.  The CTPLD makes contact with the centres, before  joint assessment and delivery of the groups by a Psychology Assistant from the CTPLD and a Psychological Wellbeing Practitioner from Mind Matters.

To facilitate the ongoing work between Mind Matters and the CTPLD, the reference group continues to meet bi-monthly.  To date we have:  Amended the referral form to flag that a person has learning disabilities or learning difficulties; introduced a flagging system for people with learning disabilities on IAPTUS; introduced the Cumbria screening tool to identify people with learning disabilities and learning difficulties; developed a flow chart for IAPT; supported Mind Matters to use Easy Read Appointment letters; developed a prompt sheet to help IAPT workers complete GAD 7 and PHQ9 with people with learning disabilities; developed Easy Read Material for IAPT workers for different types of therapy, Common Mental Health problems and for complaints together with an amended CBT manual for IAPT workers; delivered training for all 24 IAPT workers – this was videoed and is now used for all new starters in Mind Matters; developed Easy Read leaflets for Colleges / GP surgeries.

In addition, we have contributed to the revised Positive Practice Guide (2015) and presented a Poster for their launch conference; presented at a number of national conferences; won the Diversity and Equality Category in the Positive Practice in Mental Health Awards in October 2016 and were finalists in the Innovation in Mental Health category in the Health Business Awards in December 2016; and had a paper published in Advances in Mental Health  & Intellectual Disabilities.

What next

We continue to meet to ensure that the work is ongoing.  We are using same methodology to now support Mind Matters to begin to work with autistic people without a learning disability.

References

Dodd K, Burke C, Gibson A, Hines E, Howarth P, Jennison J, MacIntosh R, Radcliffe A, Viera F,  Unsworth G. (2017) Improving Access to Psychological Therapies for People with Intellectual Disabilities – Role of a Reference Group in Achieving Change. Advances in Mental Health and Intellectual Disabilities, Vol. 11 Issue: 5/6, pp.173-186.

Dodd K, Joyce T, Nixon J, Jennison J & Heneage C (2011) Improving Access to Psychological Therapies (IAPT)  - is it applicable to people with learning disabilities?  Advances in Mental Health & Learning Disabilities, 5 (1) pp. 29 – 34.

Foundation for People with Learning Disabilities (2015)  Learning Disabilities - Positive Practice Guide.  London

Dr Karen Dodd

Associate Director – Therapies LD

Consultant Clinical Psychologist