A Case For Learning Disability Doctors?

**A case for learning disability doctors.

Dr Ken Courtenay supports developing a role for doctors who are skilled in treating and supporting people with intellectual disabilities and complex health needs.**


As a psychiatrist and trained GP who works with people with intellectual disabilities (ID), I welcome Jeanne Carlin’s account of the care her daughter received from a Dutch physician trained in intellectual disabilities (Report, 24 July). She highlights the many benefits of being supported by a doctor skilled in treating and supporting people with ID and complex health needs.

Our faculty supports the exploration of developing such a role. Not only would it reduce the burden on GPs and support the work of learning disability nurses, it would potentially reduce the health inequalities faced by people with ID, who die over 20 years younger than the general population.

Psychiatrists working with people with ID offer specialist care that helps to provide substantial improvements to many people’s quality of life. As a senior doctor who understands the complex health issues faced by people with ID, an ID physician could coordinate care through a range of medical specialists. This responsibility currently falls to overworked GPs, who do not have the time or extended expertise to manage the complex health needs of people with ID.

Dr Ken Courtenay
Chair of the faculty of psychiatry of intellectual disabilities, Royal College of Psychiatrists

I’m suspicious of psychiatrist led care for those with LD, autism and complex needs - their speciality is mental health and those with the needs listed don’t have a mental health condition, unless they have it in addition to their other diagnosis. I suspect the reason the care was so good because it was given by an interested GP who had specialised.
There are some good psychiatrists out their, but there are a lot who aren’t good at treating those with LD. From the experience of friend’s sons and what I have read; even though they lead a MDT the psychiatrists aren’t very good at listening to the other professionals in the team - and push a medical model first - heavy duty meds for treating MH, even if the patient doesn’t actually have a diagnosed MH condition. It is under the very care of psychiatrists that young people have died of conditions such as constipation.


PS the best way to support those with LD etc is through meeting their needs: suitable food, exercise, social activities, structure, a sense of purpose, listening to the people & their families. A named GP like for the elderly, GPs understanding that people with LD and particularly with autism do not always present the same as neurotypical people when unwell. Medical professionals not being allowed to get away with the diagnosis, “It’s part of their condition!”