Mental health service provision for adults with intellectual disability: sources of referrals, clinical characteristics and pathways to care

There is a certain amount of ambiguity and confusion over the provision of mental health services for people with intellectual disabilities (ID) referred by both primary care services (primary care (PC)/social services (SS)) and secondary care services (generic mental health services (GMHS)). Psychosocial and clinical characteristics of new referrals (n = 791) were compared with regard to their source of referral. GMHS referrals were more likely to have schizophrenia spectrum disorder, personality disorder and mild ID and were more likely to be hospital inpatients and to have an Asian ethnic origin. PC/SS referrals were more likely to live in supported housing and require further involvement from the specialist service. These findings suggest that services are operating at two different levels, i.e. secondary and tertiary, depending upon particular service-user characteristics. Implications for the accessibility of different services and care pathways of adults with ID and mental health problems are discussed.