Page 159 - Demo

General discussion157Our studies indicate that MIDs are often missed by care professionals. In primary care 80%, and in MH services 61%, of patients with MID have no registration of their ID in their medical file (Chapters 3 and 4). GPs confirm that they often do not recognize MID and realize that they are at risk of providing care and support that does not meet the patient’s needs (Chapter 6). It was not until Bob was 25 years old that his MID was diagnosed. Before, many care professionals were involved, but he had never been tested for MID. For Bob, the establishment of MID was a tipping point, as he then was provided with more appropriate care and support.Unfortunately, Bob’s story does not include information about GPs’ role regarding his MH problems over the years. However, from our studies, it is clear that GPs play a key role in the MH care for patients with MID (Chapters 2, 5, and 6). This patient group puts a high demand on GPs, reflected in a higher prevalence of MH problems among MID patients and more consultations and types of prescriptions compared with patients with no ID or with MID alone (Chapter 3). GPs’ and MHNPs’ difficulty in providing and coordinating appropriate care and support for this patient group may lead to feelings of insecurity and frustration (Chapter 6). In addition, patients often feel vulnerable in primary care, instigated by their MID and reinforced by MH problems. This results in additional expectations and needs regarding their GP, MHNP, and network on a cognitive, practical, or emotional level (Chapter 5). Box 7.1 Characteristics of patients with both mild intellectual disabilities and mental health problems based on our findingsy Experiencing mental health (MH) problems at a relatively young agey Presenting with multi-problems in primary care, both medical and non-medical, which often need to be addressed simultaneouslyy Needing a supportive informal and/or formal network y Showing signs of being undertreated in advanced MH servicesy Experiencing more crisis interventions and MH hospital admissions y Their mild intellectual disabilities are often missed by involved care professionalsy Their general practitioners (GPs) often play a key role in providing and organizing care and support but find it difficult to fulfil this role satisfactorilyy Putting a high demand on their GPs, reflected in high number of consultations and types of prescriptionsy Feeling vulnerable in primary care because of their mild intellectual disabilities, reinforced by their MH problemsy Having additional expectations and needs regarding their GP, MH nurse practitioner, and network7Katrien Pouls sHL.indd 157 24-06-2024 16:26