Social Work with Adults who have an Intellectual Disability and a Mental Health Diagnosis

Jacinta Flynn outlines the Social Worker’s role in supporting people with a diagnosis of Intellectual Disability and mental health issues, their carers and families.

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  • It is important to understand the situation of persons with a dual diagnosis within the context of their own individual stories.
  • Social workers have a variety of skills and knowledge that they can use including counselling, advocacy and risk assessment.
  • Social workers can provide assistance during times of crisis.
  • Family, friends, community and voluntary services as well as formal services can all be part of the support system.
  • Social Workers promote equality of access to services for the person with a dual diagnosis. They also uphold the right of the person to be involved in the planning and implementation of their own supports and services.

The aim of social work is to support the person with the dual diagnosis of intellectual disability and mental health issues, as well as the people in their lives as they experience changes and losses brought about by their condition.

A person with an intellectual disability and a mental health issue may live at home with family members, independently in the community or within staffed residential services. They may live with a parent who also has a mental health diagnosis. Each person’s circumstances are unique. It is important to understand the situation of persons with a dual diagnosis within the context of their own individual stories.

The social worker can provide support before and after diagnosis, and during assessment, planning and co-ordination of services. Social workers also educate and raise awareness of mental health and intellectual disability through group work, seminars and information evenings. This may involve giving information on the early signs of dementia and linking family/carers to appropriate services such as a General Practitioner who may refer the person to a Psychiatrist for a diagnosis. We can guide the person/family/carers through the diagnostic process. We can also highlight the importance of involving family/carers in the process as they can provide valuable information at this time.

Social workers have a variety of skills and knowledge that they can use including counselling, advocacy and risk assessment. The person and the family/carers are likely to experience a range of emotions when living with a person with intellectual disability and mental health diagnosis. The social worker can provide emotional support and help them identify their own coping skills. This may involve managing day-to-day issues, long-term expectations, health care plans, housing and social welfare and end-of-life issues. Social workers can provide support where the changing care needs of the person with dementia (for example), and those of their parents, occur together. The parents/carers of the person with dementia may be elderly themselves and require additional supports as they age.

Social workers can provide assistance during times of crisis. This may include working with risk in dementia care. The term ‘risk’ can represent different things to different people: for some it is the risk of falling; for others such as family, it is the risk of loss of their relationship with the person, and for the person with dementia it can be the loss of their identity and independence. These different perceptions may lead to misunderstandings between everyone involved.  Social workers can provide support during these times.

Family, friends, community and voluntary services as well as formal services can all be part of the support system.  A social worker can also mediate and negotiate with the different services and professionals working with the person.

As social workers working within a voluntary intellectual disability service, part of our work is with adults who have a dual diagnosis. This is generally related to Dementia/Alzheimer’s or Depression/Suicidal Ideation. We are part of a multi-disciplinary team that consists of

  • Speech and Language Therapist,
  • Dietician,
  • Occupational Therapist,
  • Physiotherapist,
  • Psychologist,
  • Consultant Psychiatrist,
  • Music Therapist,
  • Leisure, Recreation and Physical Activity team and
  • Nursing and Care staff.

These practitioners can also be found within Community Care Teams. The General Practitioner may also be involved in the multi-disciplinary team.

Social Workers promote equality of access to services for the person with a dual diagnosis. They also uphold the right of the person to be involved in the planning and implementation of their own supports and services.

Jacinta Flynn is Senior Social Work Practitioner at Cope Foundation, Cork. Her areas of interest/research include Sibshops, Autism, Mental Health, Dementia, Housing. She works from a Human Rights perspective and has an interest in any legislation with regard to Disability.

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