Mental health, intellectual disability and a global pandemic

It’s been a stressful year. Not only are we grappling with a global health crisis, but experts are warning of a potential mental health crisis too.

People with intellectual disability are more likely to develop a mental health disorder than people without intellectual disability – and we would hate to see this group get left out of the conversation.

We sat down with Dr Luke Hatzipetrou, a clinical and forensic psychologist who has decades of experience helping people with intellectual disability, to find out what families and carers could doing in this time to improve the outlook for their loved ones.

Mental health and intellectual disability

Why it’s hard for people with intellectual disability to get help with their mental health (1:21)

Many people with intellectual disability can struggle to identify and communicate their feelings. This can make it tricky for them to get help if they have a mental health disorder.

Behaviours are the symptom, not the cause. (1:44)

If someone’s behaviour changes, it can be a strong sign that something isn’t quite right. Dr Luke says to be on the lookout for a change in behaviour. It might be a sign your loved one is having some trouble with their mental health. If you can treat the cause effectively, you should notice that the behaviours will subside. Changes of behaviour in someone who is having a hard time with their mental health can include:

• Aggression
• Isolating themselves
• Withdrawing from things that previously made them happy
• Prolonged sadness
• Absconding
• Agitation

How to explain mental health to people with intellectual disability (4:18)

Your loved one might not be able to identify and articulate what is going on. Mental health is a tricky concept for people to understand – whether they have a disability or not. It generally comes with a lot of big words and new experiences.

Here are some of Dr Luke’s tips:

• Explain that it’s something that they can get help with
• Be open about the process
• Encourage questions
• Talk about it normally (it’s not a thing to be ashamed of)
• Reassure them that it doesn’t define who they are.

Tips for families and carers

Always be on the lookout for changes (0:06)

According to Dr Luke, it’s not about looking at what’s worse or better, it’s about looking at what’s different.

The number one thing for parents and carers to be on the lookout for a change that’s big, distinct and persistent. Make sure to ask yourself these questions:

• How is the person interacting with the people around them?
• What is the physical environment like? (And are there any changes there?)

Trust your gut (2:21)

For parents especially, you may know more than you realise. You probably know your son or daughter better than anyone else.

There will naturally be a change in behaviour as people grow up, gain independence and embrace their own autonomy. This is called self-maturation and is normal and healthy.

If you are getting a little voice in the back of your head saying ‘something is not right here’ – it might be a good idea to explore it.

What to do if you notice a change in behaviour (3:18)

1. Start keeping track of things: Write it down with dates and times, describe behaviour, what the person looks like and any other details. It can be hard to recall these details weeks, months or even years later so this is a crucial step. It’s a massive help to any clinician if you have good information to hand. What you write down could really help make a more accurate and quicker diagnosis down the track.
2. Talk to your GP. Your GP will be able to rule out any physical causes and also give you a referral to a mental health professional if it’s needed.
3. Check in daily and let your loved one know you are there. If you’re a parent, this is something you are likely doing anyway. Even just asking questions like ‘how are you feeling today?’ or ‘Is there anything we can help you with?’ It lets your loved one know you are there for them. When experiencing mental health disorders it can often feel like no one is there, and checking in daily can give people the reassurance that you are there.

Take care of yourself (4:52)

There’s an old saying that you can’t pour from an empty bucket and that is definitely true for parents and carers.

It’s important that you are also seeking support – this doesn’t necessarily have to be psychological support. Sometimes just talking to friends, doing fun activities, and making sure you have a life and identity away from caring can make a big difference.

Make sure to rule out medical or physical causes (6:56)

A persistent change in behaviour in someone with learning and communication difficulties isn’t always caused by a mental health condition – often it can be caused by something physical that they are having trouble communicating.

It’s important that you are able to rule out any physical or medical causes before seeking mental health help.

Mental health, intellectual disability and the coronavirus

This year has been a very isolating time, and the impact of this is profound. People with intellectual disability aren’t always able to tell us about what’s going on and what they are feeling.

Importance of routine (0:29)

Dr Luke says one of the most crucial things in this time is to establish a solid routine – and it’s a routine that will likely look different to what it was before coronavirus. With boredom, comes idle thinking, which can bring you down if you do too much of it. It might mean that parents and carers need to come up with a plan B and a plan C to keep people engaged and healthy.

Help is available

• Lifeline on 13 11 14
• QLife on 1800 184 527
• Kids Helpline on 1800 551 800
• MensLine Australia on 1300 789 978
• Suicide Call Back Service on 1300 659 467
• Beyond Blue on 1300 224 636
• ReachOut at au.reachout.com
• Headspace on 1800 650 890
• Care Leavers Australasia Network (CLAN) on 1800 008 774

Resources especially developed for people with intellectual disability

• Black Dog Institute – Healthy mind