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Culnane E, Efron D, Williams K, Marraffa C, Antolovich G, Prakash C, Loftus H. Carer perspectives of a transition to adult care model for adolescents with an intellectual disability and/or autism spectrum disorder with mental health comorbidities. Child Care Health Dev 2023; 49:281-291. [PMID: 35947107 DOI: 10.1111/cch.13040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Revised: 03/23/2022] [Accepted: 08/07/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND Transition to adult care for adolescents with an intellectual disability and/or autism spectrum disorder with coexisting mental health disorders, often termed 'dual disability', is complex. It requires a family-centred approach, with collaboration among health, disability and social services and early planning. AIM To describe carer perspectives of transition to adult care and the outcomes of a transition support intervention, Fearless, Tearless Transition, for adolescents with dual disabilities piloted at a tertiary children's hospital. METHODS Carers of adolescents with a dual disability were invited to complete a survey at the commencement of their participation in the Fearless, Tearless Transition model, and again at the conclusion of the project. Within this intervention, carers and adolescents were encouraged to attend dedicated transition clinics and participate in a shared care general practitioner (GP) and paediatrician process. RESULTS One hundred and fifty-one carers of adolescents with dual disabilities were included in Fearless, Tearless Transition. Of this cohort, 138 adolescents and their carers received support in a dedicated transition clinic with 99 carers completing the initial survey at the commencement of the model. Eighty-two per cent of carers reported moderate to high levels of anxiety about transitioning from paediatric to adult care with 39% feeling 'unprepared' about transition. Eighty-one per cent reported having inadequate access to respite care with 47% reporting a lack of access to services in the community and 56% expressing dissatisfaction with their GPs. One hundred and two families participated in the shared care process with 80 GPs and 33 paediatricians. Twenty-two carers completed the second survey reporting a modest but significant improvement in preparedness for transition to adult care. CONCLUSION This study highlights the potential to improve transition outcomes for adolescents with dual disabilities and their carers through early, centralized transition planning, consistent methods of assessing adolescent and carer needs and shared care.
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Affiliation(s)
- Evelyn Culnane
- Transition Support Service, Department of Adolescent Medicine, The Royal Children's Hospital (RCH) Melbourne, Melbourne, Victoria, Australia.,University of Melbourne, Melbourne, Victoria, Australia
| | - Daryl Efron
- University of Melbourne, Melbourne, Victoria, Australia.,Department of General Medicine, The Royal Children's Hospital (RCH) Melbourne, Melbourne, Victoria, Australia.,Centre for Community Child Health, The Royal Children's Hospital (RCH) Melbourne, Melbourne, Victoria, Australia
| | - Katrina Williams
- Department of Paediatrics, Monash University, Melbourne, Victoria, Australia.,Murdoch Children's Research Institute, Melbourne, Victoria, Australia
| | - Catherine Marraffa
- University of Melbourne, Melbourne, Victoria, Australia.,Murdoch Children's Research Institute, Melbourne, Victoria, Australia.,Department of Neurodevelopment and Disability, The Royal Children's Hospital (RCH) Melbourne, Melbourne, Victoria, Australia
| | - Giuliana Antolovich
- University of Melbourne, Melbourne, Victoria, Australia.,Murdoch Children's Research Institute, Melbourne, Victoria, Australia.,Department of Neurodevelopment and Disability, The Royal Children's Hospital (RCH) Melbourne, Melbourne, Victoria, Australia
| | - Chidambaram Prakash
- Department of Mental Health, The Royal Children's Hospital (RCH) Melbourne, Melbourne, Victoria, Australia
| | - Hayley Loftus
- Transition Support Service, Department of Adolescent Medicine, The Royal Children's Hospital (RCH) Melbourne, Melbourne, Victoria, Australia.,Murdoch Children's Research Institute, Melbourne, Victoria, Australia
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Watson E, Raghavendra P, Crocker R. Mental health matters: a pilot study exploring the experiences and perspectives of individuals with complex communication needs. Augment Altern Commun 2021; 37:102-112. [PMID: 34018881 DOI: 10.1080/07434618.2021.1921845] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
Mental health and wellbeing are foundational in human interaction and life satisfaction. Persons with complex communication needs are at risk of reduced mental health and wellbeing. The aim of this project was to identify the facilitators and barriers that individuals with complex communication needs experience when attending to their mental health and wellbeing. A qualitative study design using a phenomenological approach was utilized. Data was collected through in-depth interviews with three participants with complex communication needs, observation, and reflexive journaling. An inductive process of cross-case thematic analysis identified common barriers and facilitators experienced by the participants when addressing mental health and wellbeing. The opportunity barriers described in Beukelman and Mirenda's Participation Model were applied to classify the assistive and obstructive roles of communication partners. Barriers and facilitators to obtaining assistance for mental health and wellbeing related predominantly to communication partners' skills, attitudes, and support practices. The findings highlight a need to equip individuals with complex communication needs, carers, support workers, and mental health professionals with the knowledge, skills, and attitudes to promote mental health and wellbeing among this population.
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Affiliation(s)
- Eleanor Watson
- Disability and Community Inclusion, College of Nursing and Health Sciences, Flinders University, Bedford Park, Australia
| | - Parimala Raghavendra
- Disability and Community Inclusion, Caring Futures Research Institute, College of Nursing and Health Sciences, Flinders University, Bedford Park, Australia
| | - Ruth Crocker
- Disability and Community Inclusion, College of Nursing and Health Sciences, Flinders University, Bedford Park, Australia
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Man J, Kangas M, Trollor J, Sweller N. Clinical competencies and training needs of psychologists working with adults with intellectual disability and comorbid mental ill health. CLIN PSYCHOL-UK 2020. [DOI: 10.1111/cp.12092] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Joyce Man
- Department of Psychology, Centre for Emotional Health, Macquarie University, Australia,
| | - Maria Kangas
- Department of Psychology, Centre for Emotional Health, Macquarie University, Australia,
| | - Julian Trollor
- Department of Developmental Disability Neuropsychiatry, School of Psychiatry, UNSW, Australia,
| | - Naomi Sweller
- Department of Psychology, Faculty of Human Sciences, Macquarie University, Australia,
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Man J, Kangas M. Best Practice Adherence and Workplace Facilitators and Hindrances for Psychologists Working With Individuals With Intellectual Disabilities and Co‐Morbid Mental Health Concerns. JOURNAL OF POLICY AND PRACTICE IN INTELLECTUAL DISABILITIES 2019. [DOI: 10.1111/jppi.12288] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Joyce Man
- Centre for Emotional Health, Macquarie University North Ryde NSW Australia
| | - Maria Kangas
- Centre for Emotional Health, Macquarie University North Ryde NSW Australia
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Man J, Kangas M, Trollor J, Sweller N. Clinical Practices and Barriers to Best Practice Implementation of Psychologists Working with Adults with Intellectual Disability and Comorbid Mental Ill Health. JOURNAL OF POLICY AND PRACTICE IN INTELLECTUAL DISABILITIES 2018. [DOI: 10.1111/jppi.12256] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Joyce Man
- Centre for Emotional Health Macquarie University; Sydney NSW Australia
| | - Maria Kangas
- Centre for Emotional Health Macquarie University; Sydney NSW Australia
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Cimera RE, Avellone L, Feldman-Sparber C. An investigation of the outcomes achieved by individuals with intellectual disabilities and mental illnesses. JOURNAL OF VOCATIONAL REHABILITATION 2015. [DOI: 10.3233/jvr-150762] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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