The Milbank Quarterly:

An estimated 7.4 million Americans live with intellectual or developmental disabilities (IDD). For myriad reasons rooted in genetic vulnerability, poverty, social exclusion, and discrimination, many also experience challenges to their mental health.  A recent scoping review indicates that 21%-34% of adults with intellectual disabilities experience mental health disorders, with elevated prevalence of severe mental illnesses such as bipolar disorder, psychosis, and schizophrenia.1 Many do not receive timely or appropriate mental health care.2

This care gap is exacerbated by several factors: the tendency for mental health symptoms to be misattributed to IDD (diagnostic overshadowing),3 atypical presentation of such symptoms,  communication barriers, and the common practice among community practitioners to refer people with IDD who experience such challenges to specialty clinics that often have lengthy waitlists or are poorly designed to address patients’ mental health needs.2,4

Mental health care gaps are also associated with serious harms, including heightened suicide risk, overreliance on antipsychotic medications, recurrent hospitalizations, criminal-legal-system involvement, and even early death.4 These care gaps also affect family members and caregivers, intensifying financial burdens, emotional distress, and safety concerns that often go unaddressed.5

Read more