People with intellectual disabilities

Editor—Few of the findings, recommendations, and services being developed for people with learning disabilities, as discussed by Cooper et al,¹ are being applied to people who are registered disabled with learning difficulties. This group seems to fall through the net in today's NHS; there is little to help them, even when progress has been made for intellectually disabled people in general.

Many adults with learning difficulties have common health problems that have not been addressed.²,³ In many cases neither learning disability services nor mental health services, including the voluntary sector, consider this group of patients to be appropriate for referral, assessment, or treatment. Few agencies deal specifically with learning difficulties. My discussions with adults with learning difficulties indicate that they are at a loss about where to turn for help or advice as any existing support groups are inevitably small, fragmented, and uninfluential in professional circles.

General practitioners also do not know where to refer such patients. The end result is that few treatment options for specialist attention are open to them even when identified medical problems require specialist intervention because of the learning difficulties. This in turn leads to inappropriate referrals and wasted NHS consultation time.

An example is substance misuse and eating disorders (and obesity) among people with attention deficit disorder. Between 25% and 50% of adults with the disorder use alcohol and other drugs, including food, to soothe their symptoms.⁴,⁵ However, adults with untreated symptoms of attention deficit disorder are often assessed by mental health services rather than specialist learning difficulty services in the United Kingdom. Alarmingly, these people commonly have five or more different diagnoses over time, depending on which team is assessing them. This has obvious implications for the consistency of their treatment and the credibility of their diagnoses.