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The National Health Service (NHS) has played a significant role in the lives of people with intellectual disability (ID). The NHS took over their care from local authorities in 1948 and became the main care provider until the 1980s, when long-stay hospitals closed. Since then there have been major philosophical and policy changes, with an emphasis on integration and increasing rights and access so that people with ID should be able to access mainstream health services with reasonable adjustments. These should include the provision of psychological services, for which there are still minimal therapeutic options, which are mainly behavioural (CBT). I believe that we must overcome, what I termed ‘moments of curiosity’ (see O’Driscoll, 2009) when writing about the history of psychotherapy for this group. The American historian, Trent (1994), records that ‘almost all psychodynamically oriented psychiatrists saw the retarded as hardly receptive to psychodynamic insight. Indeed, most psychiatrists … were quick to say, albeit privately, that the mentally retarded were boring’ (p. 245). The sense that this group of people are not very interesting and frankly not worth bothering with, is in my view still around today, but maybe intimated more subtly now than before. This group has been laughed at, ridiculed, abused, bullied, neglected, ignored, segregated, sterilised, castrated, and murdered – all because they lack cognitive powers. We must create adequate service provision for the ID community. To start with, the prevalence of mental health problems in people with ID is significantly higher than in the general population (Cooper et al., 2007). They are likely to have additional conditions such as autism, physical disabilities, communication difficulties, self-injurious behaviour, epilepsy and life-limiting disorders. Yet, the response to these vulnerabilities has been poor.
These are some of the reasons why I believe high-quality psychotherapy on the NHS should be available t