Using ‘candidacy’ as a framework for understanding access to mainstream psychological treatment for people with intellectual disabilities and common mental health problems within the English Improving Access to Psychological Therapies service
Abstract
Background: The Improving Access to Psychological Therapies (IAPT) service was established to address common mental health problems among the English population in a timely manner in order to counter the social and economic disadvantage accompanying such difficulties. Using the concept of candidacy, we examined how the legitimacy of claims by people with intellectual disabilities to use this service is facilitated or impeded. Method: We used a sequential mixed methods design. We completed 21 interviews with a range of stakeholders, including people with intellectual disabilities and their carers. Themes from the interviews were used to design an online survey questionnaire that was returned by 452 staff from IAPT and specialist intellectual disability services. Results: Using the candidacy framework, we noted that eligibility and access to IAPT were achieved through dynamic and iterative processes of negotiation involving people with intellectual disabilities and their supporters on one side and IAPT staff and service structures on the other. Barriers and facilitators were apparent throughout the seven dimensions of candidacy (identification, navigation, permeability of services, appearances, adjudications, offers and resistance and operating conditions) and were linked to discourses relating to the character and purpose of IAPT and specialist intellectual disability services. Conclusions: Opportunities exist for some people with intellectual disabilities to assert their candidacy for IAPT input, although there are barriers at individual, professional, organisational and structural levels. More attention needs to be paid to how principles of inclusiveness are operationalised within IAPT teams and to the mental health facilitation role of specialist intellectual disability staff.
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People with intellectual disabilities and/or autism value healthcare professionals, their support network, and other professionals who work closely with them and who have specialist knowledge and experience of working with people who have intellectual disabilities.
“People with intellectual disabilities and/or autism value healthcare professionals, their support network, and other professionals who work closely with them and who have specialist knowledge and experience of working with people who have intellectual disabilities.26,67–72”
From Barriers and facilitators to primary health care for people with intellectual disabilities and/or autism: an integrative review (2020) · cites this paper as [69]
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- Authors
- Chinn, D., & Abraham, E.
- Affiliations
- King's College London (GB)
- Corresponding author
- Chinn, D.
- ORCID
- Chinn, D.
- Venue
- Journal of Intellectual Disability Research
- Publisher
- Wiley
- Published
- 2016-04-21
- Volume
- 60
- Issue
- 6
- Pages
- 571-582
- ISSN
- 0964-2633 (ISSN-L)
- 1365-2788
- OpenAlex
- W2341016926
- Cited by
- 29
- References
- 44
- Citations by year
- 2025: 1 · 2024: 4 · 2023: 1 · 2022: 3 · 2021: 2 · 2020: 10 · 2019: 1 · 2018: 2 · 2017: 4 · 2015: 1
- FWCI
- 2.31
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Intellectual Disability Research (publishedVersion)
- PubMed (publishedVersion)
- Research Portal (King's College London) (submittedVersion)
- Funders
- Bupa Foundation
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Down syndrome and intellectual disability research
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Social Sciences › Psychology › Clinical Psychology › Psychiatric care and mental health services
- Keywords
- Improving Access to Psychological Therapies, intellectual disability, common mental disorders, access to psychological treatment, barriers and facilitators, caregivers, inclusivity, service navigation
- MeSH terms
- Adult, England, Health Services Accessibility, Humans, Mental Health Services, Intellectual Disability, Psychotherapy, Program Development, Qualitative Research
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