Page 73 - Demo

Primary mental healthcare: a Dutch database study713high number of medication prescriptions, especially psychotropics, for people with MID is consistent with earlier primary care research concerning people with ID. 2, 20, 22 From earlier research it is known that people with ID have greater healthcare needs with higher levels of morbidity and premature mortality than patients without ID, a situation to which insufficient quality of healthcare is a substantial contributor. 23 Therefore, the differences that we found in the prevalence of MH problems and provided care between patients with MID and without ID can be an indication of extra healthcare needs in this specific patient group. However, a recent review by us on primary MH care to people with ID revealed that current primary MH care to this patient group is of an insufficient standard, in terms of underdiagnosis of MH disorders, overmedication, and lack of effective patient follow-up, as well as limited GP experience in managing these patients. 9 A possible reflection of the reported difficulties in providing adequate MH care to these patients may be an additional contributing factor to the differences observed.Implications for research and practiceTimely recognition and treatment of not only MH disorders but also MH complaints are important for the physical and emotional wellbeing, and thus for the quality of life, of people with MID and therefore needs to be prioritised. 24 This requires GPs to be aware of the high prevalence of MH problems in people with MID and to be aware and knowledgeable about the effect of MID on symptom presentation, communication, and treatment. The results of this study give rise to several opportunities to improve the quality of primary MH care for people with MID. Firstly, the relatively high use of unspecified ICPC-P codes (P29, P99) and the relatively high number of people with MID who received psychotropic prescriptions could be signs that GPs experience difficulties in classifying and treating MH problems in people with MID. Communication difficulties, an atypical presentation of MH symptoms, and diagnostic masking or overshadowing, where symptoms are obscured by the ID or mislabelled, can contribute to these difficulties. 25 Therefore, research on applicable primary MH guidelines for this patient group is important. Katrien Pouls sHL.indd 71 24-06-2024 16:26