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A database study in Dutch mental health services954Implications for research and/or practiceThere is growing awareness within MH services of the high prevalence of MH disorders in people with MID and the different care needs of this group. Country-specific guidelines have been developed for these patients, 26, 27 and some examples of good practices are noticed 4, 28-30 as well as increasing attention on adapted treatment modules in research. 21, 31 Nevertheless, judging from the results of our study, further steps to improve the MH care for people with MID are needed, not only at care professional level, but also at scientific, organisational, and policy level. MH service professionals should be aware of the importance of identifying and registering MID, primarily for good care provision, but also for research purposes. Recurrent education programmes on this topic for MH service professionals can be an important tool to improve this awareness. Also, screening for ID in the intake procedure can help to identify an MID at an early stage, enabling adjustments in communication and in diagnostic and treatment protocols from the start. Some useful ID screening tools developed for this purpose are applicable in MH services, but they need to be further implemented in daily practice. 16, 32 At scientific level, adequate ID registration enables researchers to learn in more detail about patient-, care professional-, and organisation-related factors that contribute to observed differences in health and care provided to patients with MID and without ID. Given the diagnostic classification difficulties indicated by our study, further research is needed on the applicability of classification instruments for MH symptoms in patients with MID. In so doing, it is important to focus not solely on the DSM, but also on alternatives, such as Diagnostic Criteria for Psychiatric Disorders for Use with Adults with Learning Disabilities (DCLD), 33 Diagnostic Manual Intellectual Disability (MD-ID-2), 34 or Dôsen’s integrative approach. 35 Finally, also at organisational and policy level, steps need to be taken to improve the quality of MH services for patients with MID. In daily practice, this can already be achieved by using existing instruments like The Green Light Toolkit, an audit instrument for MH services developed in the UK, 36 to improve the accessibility of MH services, but investment in initiatives on optimal, country-specific, collaborative MH healthcare models, including incentives for payment, will also contribute in this matter.Katrien Pouls sHL.indd 95 24-06-2024 16:26