Psychiatry of intellectual disability in the UK: looking back, moving forward
Shankar, Rohit Tromans, Samuel, J Laugharne, Richard Courtenay, Ken Sawhney, Inder Roy, Ashok Alexander, Regi
Shankar, Rohit
Tromans, Samuel, J
Laugharne, Richard
Courtenay, Ken
Sawhney, Inder
Roy, Ashok
Alexander, Regi
Affiliation
University of Plymouth; Cornwall Partnership NHS Foundation Trust; University of Leicester; Leicestershire Partnership NHS Trust; North London NHS Foundation Trust; Hertfordshire Partnership NHS Foundation Trust; Coventry and Warwickshire Partnership NHS Trust; University of Hertfordshire
Other Contributors
Publication date
2025-09
Subject
Collections
Research Projects
Organizational Units
Journal Issue
Abstract
In this century, psychiatry for people with intellectual disability in the United Kingdom has undergone profound shifts, shaped by deinstitutionalization, legislative reform, a focus on psychotropic reduction, an increasing recognition of the premature mortality, and a growing recognition of rights-based, person-centred approaches. Despite progress, entrenched challenges remain, including fragmented services, inconsistent outcome measures, inappropriate psychotropic prescribing, and health inequalities. The coming decades promise transformative opportunities through genomics, digital health, and personalized interventions, through integrated management of co-occurring conditions, but risk deepening inequities if inclusion is not intentional. This paper synthesizes past developments, including the impact of abuse scandals, legal reforms, medication optimization initiatives, recognition of premature mortality, outcome measurement advances, and evolving care models. It explores future trajectories, focusing on genomic medicine, technology, holistic care, and patient and carer co-production, emphasizing the role of shared genetic vulnerabilities and digital phenotyping in early detection and integrated care. By reflecting on past shortcomings and future potential, we propose an agenda that centres rights, equity, and evidence, ensuring that people with intellectual disability are not left behind in the next era of psychiatric innovation and equally that psychiatry remains integral to the welfare of people with intellectual disability.
Citation
Shankar R, Tromans SJ, Laugharne R, Courtenay K, Sawhney I, Roy A, Alexander R. Psychiatry of intellectual disability in the UK: looking back, moving forward. Int Rev Psychiatry. 2025 Sep 29:1-12. doi: 10.1080/09540261.2025.2564166. Epub ahead of print. PMID: 41017466.
Type
Article