Mental Health and Learning Disabilities

Today is World Mental Health Day. 

In recent times there has been a real increase in the awareness of mental health issues. More people are seeking help for mental health issues than every before. That’s a really good sign. Yes, we still have some way to go but it is starting to feel like the stigma is finally fading.

Everybody has a mental health and we all face challenges in our emotional wellbeing at some point in our life. That includes people with learning disabilities.

In fact, research shows that people with learning disabilities have a greater chance of developing mental health issues. There’s lots of reasons why that might be: a smaller circle of friends; lack of opportunities; lack of control over their own lives; long term medical conditions; attachment issues as a result of their learning disability; or because they struggle to understand and express their emotions. Mental health issues can also come up without a specific cause.

It’s easy to dismiss someone hitting out at others, refusing to get out of bed or smearing faeces as them just being difficult (especially when you’re the one that’s being hit!). I’ve also heard it said ‘they’ve got a disability, they don’t know what they’re doing.’

But let’s look at it from a different angle. Many people with learning disabilities have difficulties in verbal communication and some can’t (or don’t) use words at all.  Take a step back from that. How would you communicate your pain if you could not speak?

By hitting out, that person could be communicating their pain at not being understood; by refusing to get out of bed they could be saying ‘I really don’t want to face the world today’; by smearing faeces they could be trying to tell you about their distress, and in some cases could be an indication of abuse.

Music therapy can be really helpful for people who struggle to talk about their mental health issues. In music therapy the person does not have to behave in a certain way and I respond musically to whatever the client brings to the session. If a person starts rocking that could become the rhythm of the music. If they make a vocal sound, I’ll improvise around that. If they move from instrument to instrument without paying any attention to me I might play a drone or keep a steady beat on the drum to show that I am still there and not going anywhere! I’m always trying to create a containing environment where the person can feel safe and listened to. It can take time to build a relationship, especially with people who feel they haven’t been listened to for a long time.

If you want to explore this further, I highly recommend Valerie Sinason’s book ‘Mental Handicap and the Human Condition’. This is one of the first books I read during my music therapy training and it really helped my understanding and changed my perspective. It was the first book ever written by a psychoanalyst that focuses on the emotional health of people with learning disabilities. It’s probably a bit too much to go into in this blog post, but Sinason also talks about the idea of a ‘handicapped smile’- a fixed smile used by some people with learning disabilities to hide their pain and soften the blow of their suffering to people in the outside world.


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