Theme 5: Healthy living The physical and mental health of young people with intellectual disability is a critical indicator of current and future wellbeing. Given this cohort experiences a range of comorbidities, the complexity of need and required support is an ongoing consideration for young people, carers and service providers. Through our conversations and work, we found that young people can fall through the gaps in the health system, encountering inequities and barriers to accessing critical services. We came across a range of issues including the level of preparedness and capacity of the health system to support young people with more complex needs, especially when it involves mental health problems. We also found there are opportunities for improved outcomes to be delivered through a more integrated care model, one that involves health and disability services working closely together.
Prepared health and mental health services Young people with intellectual disability often have more complex health needs compared to their peers and require access to a broad range of health services and supports. It is critical that they have access to have health services and professionals who understand how to support and care for their needs. Through our conversations with young people and carers, and interviews with health leaders, we found a range of issues impacting on outcomes including skill and capability gaps across professions. We heard from carers about the challenges in finding appropriately experienced health professionals. They noted instances where checkups were avoided, as they were too difficult to manage when hospitals and clinics were unable to understand and support the complexity of need. Overall, Australians with intellectual disability experience stark health inequalities compared to the general population. For instance, they experience twice the rate of avoidable death, lower rates of preventative healthcare and twice the rate of hospital admissions.72 Health professionals face challenges communicating with people
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with intellectual disability, distinguishing health problems from disability and diagnosing complex health conditions. Most health professionals receive little or no training in intellectual disability healthcare.73 In the area of mental health, the issue is particularly pronounced. It is estimated that 57 per cent of all people with intellectual disability have a mental illness74 and are more likely to experience mental health problems during their transition to adulthood than the broader population.75 Yet when young people seek mental health support, they often face challenges in accessing quality and appropriate services. We found from our interviews with health leaders that some services do not have the skills or capacity to deliver specialised care; care that recognises and caters for specific needs. Disability service providers and health leaders noted that, as a minority group, young people with intellectual disability are often overlooked across mainstream policy areas. Despite experiencing some of the largest health inequalities in Australia, health policies and initiatives often lack explicit recognition or consideration of people with intellectual disability.
Future directions Specialised health workforce Through our study, we found a pressing need to upskill health and mental health professionals across the primary health network in supporting and caring for young people with intellectual disability to ensure greater equity in access to services. This will require the development of a broad set of strategies, including integrating relevant content into health qualifications and curriculum; training programs specifically aimed at improving capacity of health professionals in intellectual disability healthcare; implementing consistent competency requirements for practising professionals; and developing evidence-based tools to support diagnosis and delivery of health and mental healthcare. Health services need to be made more accessible to young people with intellectual disability. This should include a focus on in-home visits and other adjustments to care settings that accommodate their needs.
Simpson, J. 2019. The health of people with intellectual disability: Budget and federal election 2019 commitments sought from Australian political parties. Council for Intellectual Disability. ibid.
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Trollor, J. & Small, J. 2019. Health inequality and people with intellectual disability – research summary. Faculty of Medicine, Department of Developmental Disability Neuropsychiatry 3DN. Sydney: UNSW.
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Dew, A., Dowse, L., Athanassiou, U., et al. 2018. Making mental health policy inclusive of people with intellectual disability. Faculty of Medicine, Department of Developmental Disability Neuropsychiatry 3DN. Sydney: UNSW.
40 | Reaching Potential
