When someone with a learning disability develops mental health problems it is likely that their relatives or carer will be the first to notice any changes in their behaviour, but they may not necessarily know what to do. Mary Jane Spiller and Steve Hardy describe the development of an award-winning guide that offers practical solutions to difficult situations

People with learning disabilities are at greater risk of developing mental health problems than the general population, with prevalence rates of 20 per cent having been found in a recent study (Taylor et al 2004). The vulnerability of this group is complex and involves biological, psychological and social factors that impact on the mental health of the individual (Hardy and Bouras 2002). Cooper (2003) states that as well as having all the risk factors that are relevant for the general population, people with learning disabilities may have extra risk factors. These may include: behavioural phenotypes (from underlying genetic disorders), multiple prescribed medications and drug interactions, poor parent-infant bonding, childhood and adult exploitation, limited choices and opportunities and limited communication skills.