Children with intellectual disabilities face greater mental health difficulties when they are from a disadvantaged background, finds a new study led by UCL researchers.
The study, published in JCPP Advances, found that children and young people with intellectual developmental disabilities (IDD) from more socioeconomically disadvantaged backgrounds experience greater emotional and behavioural difficulties and are more likely to report mental health conditions.
Lead author, Honorary Research Fellow Irene O Lee (UCL Great Ormond Street Institute of Child Health), said: “Children with intellectual developmental disabilities can face significant mental health challenges, and families experiencing socioeconomic disadvantage may have additional difficulties in accessing the support they need.
“Our findings highlight the importance of looking beyond a child’s disability and recognising how family circumstances may be associated with their mental health. Improving access to appropriate mental health and social care support is an important step towards reducing these inequalities.”
The research team examined 2,778 children and young people between the ages of four and 25, across the UK from the UK-wide ‘Intellectual Disability and Mental Health: Assessing the Genomic Impact on Neurodevelopment’ (IMAGINE-ID) cohort, who had intellectual developmental disabilities caused by genetic conditions – such as 16p11.2 microdeletion syndrome, Prader-Willi or Angelman syndrome – some of whom had inherited variations.
Parents or caregivers completed detailed questionnaires about their child’s health, development and behaviour.
Meanwhile, socioeconomic disadvantage was measured using three main indicators: neighbourhood deprivation (according to the Index of Multiple Deprivation), eligibility for free school meals and parental education level.
The researchers then linked the questionnaire responses with the measures of deprivation to examine how social disadvantage relates to mental health outcomes.
They found that children with IDD who were living in more deprived neighbourhoods, those eligible for free school meals, and those whose parents had lower levels of education were more likely to experience emotional and behavioural difficulties (such as low mood, stress-related physical symptoms, conduct problems or peer relationship problems).
They were also more likely to have mental health conditions including depression, anxiety, attention deficit hyperactivity disorder (ADHD) and conduct disorder. (*see graph below).
Children eligible for free school meals were 2.5 times as likely to have a reported diagnosis of major depression and 2.3 times as likely to have conduct disorder as children who were not eligible.
The researchers found no clear pattern showing that children with more severe learning disabilities experienced greater mental health difficulties. Instead, socioeconomic disadvantage was consistently associated with poorer mental health outcomes.
Senior author, Emeritus Professor David Skuse (UCL Great Ormond Street Institute of Child Health), said: “Our evidence reinforces the necessity of recognising the wider challenges faced by families caring for children with intellectual developmental disabilities. Financial pressures, caring responsibilities and difficulties accessing specialist support may add to the challenges these families experience, although this study could not establish the reasons behind the associations.”
The IMAGINE-ID study also involved researchers from Cardiff University. It was funded by the Medical Research Council (MRC).
Study limitations
Most information came from parents rather than independent assessments, some families did not complete all questionnaires, and factors such as family circumstances, deprivation and the severity of disability could not be measured in detail.
In addition, the study provides a snapshot at one point in time, so it cannot show whether disadvantage causes mental health difficulties or whether the challenges of supporting a child with intellectual and developmental disabilities can contribute to financial hardship for families.
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