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Who should care for people with learning disabilities?

BMJ 2000; 321 doi: (Published 18 November 2000) Cite this as: BMJ 2000;321:1297
  1. William Sellar, consultant ophthalmologist with an interest in learning disability provision
  1. Whitehaven

    The medical care of people with learning disabilities in the United Kingdom is largely the responsibility of psychiatrists, for whom it has become a recognised subspecialty. This responsibility has been inherited because, in the past, many people with learning disabilities were condemned to asylums for psychiatric patients as both groups of patients had behaviour that was unaccepted in the wider community and which seemed to be untreatable.

    However, although people with learning disability have an increased incidence of psychiatric disorder, most people with mental handicap are now recognised as not having psychiatric illness. So why are they still managed by psychiatrists?

    Many adults with learning disabilities disappear anonymously into the community

    Psychiatrists may argue that they are best placed to understand, differentiate, interpret, or treat the altered behaviour of those with learning disability who may find difficulty expressing themselves. Neurotic or challenging behaviour may indicate …

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