Katie Brooker

Asking the Right Questions

Mental illness often presents differently in people with intellectual disability, who may struggle to articulate verbally how they are feeling, due to communication difficulties related to their disability. The Disability Royal Commission was critical of the extensive barriers people with intellectual disability face when accessing mental health care and the lack of education and training the mental health workforce receive to recognise the signs and symptoms of mental illness in people with intellectual disability. This leads to mistaken ascribing of behavioural change to the person’s intellectual disability, a concept called ‘diagnostic overshadowing’. The barriers are further exacerbated for First Nations people and people from culturally and linguistically diverse backgrounds, where mental illness may also present differently due to cultural reasons. Health professionals report low confidence when working with people with intellectual disability.

The net result is people with intellectual disability miss out on receiving an accurate diagnosis of their mental health concerns. Ultimately, missed diagnosis leads to an increase in disability burden by perpetuating the psychosocial effects of an untreated mental illness. Unfortunately, the converse also occurs, where mental illness may be mistakenly diagnosed, leading to unnecessary, inappropriate, costly and ineffective treatments.

There are no suitable tools to support general mental health professionals to ask the right questions and make sense of the answers they receive from a person with intellectual disability, and their family and supporters, in a general mental health setting. We are looking for a HDR student to join our team of people with intellectual disability, clinicians and researchers, to work collaboratively to co-design a guided interview tool and implementation resources to assist mental health professionals to ask the right questions in a mental health assessment for a person with intellectual disability. Our vision is people with intellectual disability will receive accurate diagnosis and therefore treatment for their mental health needs.

Bridge to Better Health

People with intellectual disability experience significant health disparity and engage in less preventive health actions than the general population. Practice nurses are now common in general practice and are an untapped resource for building capacity in intellectual disability health in primary care. We will deliver an intervention which includes (i) specialised intellectual disability nurse support, (ii) training for practice nurses to deliver the CHAP annual health assessment tool, (iii) an online primary care education package; and (iv) online resources. A cluster-randomised trial design will be used to evaluate the evidence for improved preventive health outcomes including vaccinations, metabolic syndrome screening and cancer screening in people with intellectual disability aged 15 years and over.