Psychologists’ adherence and carer experiences with best practice in intellectual disabilities and co-morbid mental ill health

This thesis explored Australian psychologists’ perceptions of best practice when working with individuals with an intellectual disability and co-morbid mental health disorders and its alignment with carer experiences. The first study explored assessment practices, perceptions of workplace resources, training needs and barriers to evidence based practice of Australian psychologists working in intellectual disabilities via an online survey. Study two involved focus groups with psychologists working in intellectual disabilities and investigated their perceptions of best practice, adherence to practice guidelines and impact of organisational factors. The final mixed method study used online surveys and face to face/phone interviews to explore experiences of carers with an offspring with dual disabilities with mental health and disability services. This study also assessed carer mental health literacy and barriers to help seeking. Overall, findings indicate that psychologists are generally aware of best practice principles and reported clinical practices that are aligned with current international and national practice guidelines. Psychologists showed limited confidence in mental health diagnosis with individuals with an intellectual disability and expressed a need for further training in dual disabilities. Organisational and systemic factors were found to create barriers to evidence based practice implementation and practice based evidence was noted to compensate for the limited evidence based available to guide clinical practice. Carers reported varying experiences of helpfulness and satisfaction with mainstream mental health and disability services. Carers also generally showed high mental health literacy and reported few attitudinal barriers to help seeking. Carers also noted more negative than positive experiences with services received for their offspring with dual disabilities. Findings suggest there is much improvement to be made in a range of areas to improve the experience of carers with services to address mental health concerns. Findings from this thesis have implications for clinician training, organisational operations, service models of care, practice guideline implementation and practice based evidence.