Evaluation report
COVID-19 and young people with intellectual disability: a service review
Minhas O, Mundy P, Stewart J ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This service review examined how the first COVID-19 lockdown affected children and young people with intellectual disability in South Wales between March and May 2020. The review found a tenfold increase in crisis calls to specialist mental health services during lockdown compared to the pre-COVID period, with 95% of these calls resulting in increased psychotropic medication. The disruption to school, respite care, and community support systems was identified as a key factor in the deterioration of children's wellbeing and behaviour. The findings highlight that children with intellectual disability depend on complex, interconnected support systems, and disruptions to these systems lead to increased use of medication rather than psychosocial interventions.
Key points
- Pre-COVID baseline: 2 crisis calls over 8 weeks; COVID period: 20 distress calls (10-fold increase)
- 95% of distress calls during lockdown resulted in medication increases or new prescriptions
- 75% of children making distress calls were boys, ages 9-17 (mean 13.2 years)
- Return to school was identified as a key protective factor for improved wellbeing
- Disruption to integrated support systems (schools, respite care, healthcare) led to medication-focused interventions rather than psychosocial support
Limitations
This is a service review of a single specialist team across six clinical areas in one UK region during an 8-week snapshot period, so findings may not be generalizable to other regions, countries, or healthcare systems. The review does not include direct interviews with families or young people themselves, and lacks comparison with other disability groups or the general child population during the same period.
Abstract
Aims A service review of specialist child and adolescent intellectual disability provision in South Wales was conducted between March and May 2020. The purpose was to explore the impact of the first COVID-19 pandemic lockdown on children with intellectual disability and their families. The review aimed to explore if the disruption to the systems involved in their care would impact their wellbeing and behavioural presentations. We also measured if there had been an increase in the use of medication. Our focus was on the distress calls, which are requests for urgent clinical review to prevent a crisis.A service review of specialist child and adolescent intellectual disability provision in South Wales was conducted between March and May 2020. The purpose was to explore the impact of the first COVID-19 pandemic lockdown on children with intellectual disability and their families. The review aimed to explore if the disruption to the systems involved in their care would impact their wellbeing and behavioural presentations. We also measured if there had been an increase in the use of medication. Our focus was on the distress calls, which are requests for urgent clinical review to prevent a crisis. Method Six clinical areas across three Welsh health boards under the same specialist team were surveyed. Case notes and email correspondence were reviewed to obtain the number and content of crisis calls made to specialist CAMHS across an eight week period during the first UK COVID-19 lockdown. Data were gathered on frequency, purpose, and outcome of calls. Comparison data were also collected for the period October 2019 to March 2020. Result Pre-COVID-19: Two crisis calls were identified in two different areas during the pre-COVID period surveyed. Increases in medication and increases in respite care packages were made as a result. During COVID-19 restrictions: 20 different initial distress calls made (children age 9 and 17 years old (M = 13.2); 75% were boys) across five of the six clinical areas. Of these 20 calls, 17 were active cases and 3 were new referrals. 95% of calls resulted in medication increases and there were few other interventions used due to COVID-19 constraints. Changes to the child's support system were discussed across all cases and return to school was highlighted as a key protective factor in improved well-being. Differences between clinical areas were also identified. Conclusion There was a clear increase in distress calls and requests to prescribe or increase psychotropic medication to calm the distress during the ‘lockdown’. Changes in behavioural presentation may have occurred partly due to the disruption to the complex systems that typically support a child and the shift away from community support. Children with intellectual disability and their families are unique and embedded in complex systems comprising schools, respite, and healthcare provision which work together to deliver optimal mental healthcare with psychosocial interventions with medication for higher-risk situations. Any shifts in these systems may lead to an imbalance and a higher likelihood of medication use.
Findings the Hub has extracted
Each claim below is labelled by its type of design and links back to this report.
- Intervention
- Service continuity and medication management during COVID-19 lockdown restrictions
- Population
- Children and young people with intellectual disability (ages 9-17) receiving specialist child and adolescent mental health services in South Wales
Key finding
Crisis distress calls increased from 2 to 20 over equivalent 8-week periods (10-fold increase)