– The intensity of the change in behaviour or feelings (how easily they are calmed or distracted) – The frequency of the changes (how often they take place, how spaced apart they are, or any patterns you notice) (179) Conflating usual behaviour with poor mental health It is particularly important that you understand the young person’s ‘norm’ because often usual behaviour and habits for a person with a learning disability can be mistaken for signs of poor mental health. Here are some examples: – Special interests or unique routines, e.g. a fixation with a TV character, which can be a helpful way of coping, can be mistaken for obsessive compulsive disorder. – Delusions are not always the result of poor mental health, e.g. the young person may think they are being controlled by others as people with a learning disability often have less control over their lives. – It is not uncommon for people with a learning disability to talk to themselves or repeat conversations they have heard, which can be mistaken for them experiencing hallucinations. – Some disordered eating may be related to the young person’s disability i.e. their sensory preferences, or medications they take. However, do not dismiss signs of a potential eating disorder. – Challenges with communicating coherently or being physically unsteady or disoriented may give the impression that the young person has been using alcohol or other drugs, but there may be other reasons for this that require medical attention. If they have taken alcohol or drugs, they may have difficulty understanding the consequences of their substance use. – People with an intellectual disability may self-harm for a range of reasons, e.g., to communicate a basic need such as hunger,
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