Intellectual Disability Psychiatry in Wales

Intellectual disability psychiatry, also known as learning disability psychiatry, is a sub-specialty of psychiatry that trainees can consider specialising in for the final 3 years of their psychiatry training.

Intellectual disability (ID) psychiatrists work alongside adults with intellectual disability to diagnose and treat mental illnesses, however their work can also be much wider and more varied than treating mental disorders alone. This is often because if patients are unable to articulate their thoughts and feelings easily, wider differential diagnoses may also need to be considered. This could include the non-specific presentation of an underlying physical health condition or numerous social factors.

Formulation skills using the bio-psycho-social model are embedded within ID psychiatry practice, meaning that clinicians will often work in muti-professional teams and draw on the expertise of wider professional groups (such as nursing, SALT, OT, psychology, dieticians, behavioural specialists and physiotherapists). The role also involves liaising with families and external agencies such as social workers, care providers, GPs and the criminal justice system, and so good organisational and communication skills are essential. Most ID psychiatrists work in the community and review patients in clinics or at home, however there are specialist inpatient jobs also available. Additionally, Wales is the first place in the UK to pilot a ID Liaison Consultant working in the general hospitals.

ID psychiatrists work with adults across the life-span meaning that the range of psychopathology seen can be very broad and can include neurodevelopmental disorders present since childhood, such as autism and ADHD, as well as neurodegenerative conditions typically seen later in life, such as dementia. People with ID also have a higher prevalence of common mental illnesses such as depression and anxiety compared with the general population. ID psychiatrists also have a role in managing epilepsy, particularly for patients who experience behavioural changes in response to either seizure activity or medication side effects.

The ID Faculty in Wales is made up of the members, who work as ID psychiatrists across Wales. The majority of the members are Consultants. The faculty meet virtually twice a year. A recruitment working group was also set up in 2021 to tackle national recruitment concerns into the speciality.

One of the faculty’s recent successes has been to get an agreement in place between all of the health boards in Wales regarding guidelines for the safe transition of psychiatric care for patients with ID moving between health boards and this work was completed in September 2022.

The Chair of the RCPsych Wales ID Faculty also attends national RCPsych ID executive college meetings and sits on the RCPsych Wales Devolved Council and on the LD Ministerial Advisory Group. The current Chair is Dr Harriet Slater (2020- present).

The role of Vice-Chair is currently vacant, and we are inviting expressions of interest in the role. Please contact the Wales office by Friday 10 November should you be interested in the role.

Many thanks to Dr Lance Watkins who extended his term in office from 2019-2023.

We’ve collated some useful training resources on Intellectual Disability Psychiatry for medical students and trainees.

Great stuff! Wales is a highly rewarding place to work and train.

Find out more on the Health Education and Improvement Wales (HEIW) website

Our training programme director, Dr Andrew Isaac, would also be very happy to hear from you and can answer any questions that you may have about higher training in intellectual disability psychiatry.