Developing inclusive environments in mental health provision for people with disabilities

Whitehead, Graham and Barnard, Adam (2013) Developing inclusive environments in mental health provision for people with disabilities. Journal of Mental Health Training, Education and Practice, 8 (2). pp. 103-111. ISSN 1755-6228


– The increased use of mental health interventions employing cognitive behavioural therapy (CBT) over the last decade raises the significant theme of the efficacy of such treatments for people with disabilities. Recent evidence‐based studies regarding the application of cognitive behavioural interventions for people with disabilities have highlighted issues concerning access to services, questions of engagement and efficacy of the cognitive aspects of CBT practice and service models and forms of delivery. The purpose of this paper is to explore these themes with particular emphasis on barriers to accessibility for this population and provide consideration of ethical and effective practice aspects of psychological interventions in response to the recent World Health Organisation recommendations on disability provision.

– The paper considers the development of the “enabling environments” theme for people with disabilities within a mental health context within Europe, with a view to exploring barriers to social inclusion and service user autonomy. The paper is designed to review and enhance existing literature in the field and to question the philosophical position of cognitive‐behavioural approaches to mental health provision in a European context.

– Consideration is given to the use and application of CBT and evidence‐based practice (EBP) and considers efficacy in mental health provision for this population. Consideration is also given to the efficacy and appropriateness of short‐term interventions for this population.

Research limitations/implications
– As a conceptual paper, the limitations of the discussion are that the views expressed are solely those of the authors but the paper usefully develops consideration of the existing literature in the field and discusses the implications of developing inclusive practice in mental health provision for this population.

Practical implications
– The issues discussed in the paper offer significant questions relevant to the delivery of mental health provision for people with disabilities from a European perspective. Practical implications relate to the development of inclusive practice for practitioners in the delivery of these services.

Social implications
– The social implications of the paper are significant, as the issues discussed raise questions about how mental health services approach their provision for people with disabilities. From a social context, the conceptual discussion offers insights useful to develop effective mental health provision and promote service user responsibility and autonomy.

– As a conceptual paper, the originality of the submission relates to questioning the efficacy of more recent developments in the mental health field re: philosophy of approach and method and recommendations are offered by the authors which may impact service delivery, the focus of relevant evidence‐based practice and service user autonomy.


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