The differences between mental illness and intellectual disability

WHY ARE THE DIFFERENCES IMPORTANT?

Intellectual disability and mental illness are often confused. However, they are very different! Only if you know about the differences, both groups can be treated adequately. Mental illness is an illness and can be cured, whereas intellectual disability is a life-long condition. This leaflet sets out to explain the most important differences between intellectual disability and mental illness. People with mental illness need mental health care, medical and psycho- therapies. In general they have no intellectual impairment and can live independently when their mental health problem is controlled. People with intellectual disability are not ill, unless they have a common illness. They need easy-to-understand information, education or training to live included in society. Treating the two different groups as one leads to wrong assumptions, faulty service planning, and often to discrimination of one group by the other. It is clear that medical doctors, therapists and education professionals must be able to distinguish the two groups as basis for adequate interventions. But also policy makers at local, national and European level must recognise the differences to be able to provide for both groups the necessary support systems.

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INTELLECTUAL DISABILITY

Intellectual disability is a condition where people have significant difficulties in learning and understanding due to an incomplete development of intelligence. Their skills in areas such as cognition, language, motor and social abilities can be permanently impaired. Between 1% and 3% of the population have an intellectual disability. The causes may be genetic, but also environmental factors during pregnancy.

Most needs of people with intellectual disability are very equal to other people: social contact, security, adequate housing, education, work, etc. People with mild intellectual disability might need some additional education, but can live independently with some support. People with more severe disability often need life-long educational and social support. Any services for people with intellectual disability must be oriented to increase their abilities and their inclusion into normal life of society.

Education and therapies, which facilitate and support development, can greatly improve the abilities and independence of people with intellectual disability. Therefore, early identification and early intervention are important to promote the recognition and optimal development of the capacities and self-determination of the individual. Access to inclusive education at school age and beyond enhances the abilities for self-care. Vocational training and work opportunities as well as community-based living facilities and group homes provide the skills and possibilities for adult life included in the community.

For people with intellectual disability, accessibility of information is of central importance. They need information in easy-to-understand format to participate fully in the life of society.

In recent years, people with intellectual disability increasingly claim the right to speak for themselves and to be consulted regarding any decision that effects their lives. This democratic principle c hal lenges and changes old models of care and treatment and leads to a full participation of people with intellectual disability in society.

MENTAL ILLNESS

Mental Illness is a disorder that affects feelings and behaviour. Few mental illnesses can be prevented; nearly all can be successfully managed and treated. 25% of all people develop mental or behavioural disorders at some stage in life. The causes of mental illness are complex and influenced by a person's heredity (genes), stressful life experiences, difficult family background, physical illnesses, etc. People with mental health problems often have difficulties in coping with the pressures of daily life and can loose their jobs, their benefits, their parental rights, and their basic human rights.

The most common mental illnesses are the following:
•  Depression – characterized by sadness, decreased energy, loss of interests, sleep and appetite disturbance, feelings of guilt and hopelessness. Suicide remains one of the common outcomes of depression.
•  Schizophrenia : is a disorder that is characterized by profound disruptions in thinking, affecting language, perception, including psychotic experiences. It can cause hal lucinations, fear and bewilderment.
•  Anxiety disorders – include phobic, panic and general anxiety (such as worry, tension, over-breathing), which can cause significant distress and disability.

Because of the complex causes, a diversified and combined treatment is often proposed, such as medication, psychotherapy, family therapy, etc. Treatment takes place in different settings: psychiatric hospitals, psychiatric wards in general hospitals, outpatient mental health services, community mental health services, or private psychiatrists or psychotherapists. It is important that treatment in hospitals is limited to the shortest possible period of time. Self-help groups can also be of great help (share feelings and experiences).

DISCRIMINATION, NEGLECT AND ABUSE

Both, people with intellectual disability and people with mental illness, suffer from prejudices, negative attitudes, degrading treatment, abuse and discrimination in society. They are often discriminated against by employers, social and health services, or housing societies and in the access to goods or to financial services. They experience painful emotions, being out of control, or loosing all they have.

They need respect, based on knowledge and understanding of their situation. They need also the solidarity of society to provide the necessary quality services. And they need commitment to include them in every aspect of life.

Both groups need alternatives and choices of services. Hospitals can only be for short-term interventions. Large residential institutions are segregating, tend to violate the human rights of their inhabitants and should be closed.

Several human rights instruments protect both people with intellectual disability and those with mental illness:
•  European Convention on Human Rights
•  UN Standard Rules on the Equalisation of Opportunities of People with Disabilities
•  UN Convention against Torture and Degrading Treatment
•  UN Convention on the Right of the Child

Raising awareness and the profile of both groups at all levels, be it with politicians, health workers, teachers or employers, together with fighting taboos, stigma and discrimination can help people with intellectual disability or mental illness to exercise their rights as full citizens.