Social Work, Alcohol and Drugs  
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Disability and Ill Health - Learning disabilities


Assessment

Assessing the substance use of people with learning disabilities needs to take into account the extent of the disability and the extent to which it will affect their involvement in the assessment.

Before the assessment begins you need to establish the person’s level of understanding and communication skills and ensure that everything possible is done to involve the person in the assessment.  It may be necessary to use a range of communication tools in the assessment but these will need to be available prior to attempting the assessment.

This may be done best through a partnership arrangement between two specialists, one with the alcohol or drug knowledge and the other with experience of working with the person or an advocate who has experience of working with people with learning difficulties.  Assessment tools may need to be designed between them.  The Foundation for People with Learning Disabilities (2004) has called for closer partnership working with alcohol and drug agencies to ensure people’s needs are met and services delivered appropriately. 

Good practice example
The Foundation for People with Learning Disabilities (2004) had published a two part document for providers of mental health services entitled ‘Green light for mental health: how good are your mental health services for people with learning disabilities?’.  Part A is a service improvement toolkit that references Preston Primary Care Trust as an example of partnership working.  A member of the learning disability team has provided “input into the mental health substance misuse service…to assist with developing appropriate screening tools and ways of communicating with people who have learning difficulties”.  Further information is available from Andy Shaw on 01772 401200 or Andrew.Shaw@PrestonPCT.nhs.uk.

If partnership working is not immediately possible you need to ensure that you have adequate training in alcohol or drug use to know what to ask, how to ask it, and the implications for the person’s responses in relation to what you do next, eg. refer on for specialist assessment or provide a brief intervention yourself. (See website sections on ‘Assessment and Treatment’ for further information.)

It will not be appropriate necessarily to have a family member or carer present.  Disclosing substance use, and any related problems, is not easy and most people who find the courage to do this want to do it in confidence.

 

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