Evidence Based Practice in Mental Health Nursing

One of the most common and disabling psychological disorders encountered within mental health and general medical settings is that of an anxiety disorder (Dattilio & Kendall 2000). Research has indicated that people with learning disabilities are more prevalent to psychological disorders than the general population (Hassiotis et al 2000) consequently it could be hypothesised that prevalence rates of anxiety disorders are similar if not greater within the learning disabled population. Professional literature suggests that cognitive-behaviour therapy (CBT) has been an effective treatment against anxiety disorder (Beck 1995) however; this literature has predominately concentrated its focus to within the confines of mental health and general medical settings (Dattilio & Kendall 2000). The ability of people with learning disabilities to identify, evaluate and respond to their dysfunctional thoughts and beliefs, fundamentals of CBT (Beck 1995) have put into question the very use of this treatment programme for this particular client group (Kroese et al 1997). From a professional and personal perspective and through the utilisation of the Seedhouse (1998) 'Ethical Grid' responding to an anxiety disorder by way of CBT could be considered an ethically acceptable clinical intervention. Nationally and locally through government directives, 'Valuing People' (Department of Health 2001) and initiatives such as Health Action Plans (Department of Health 2002) services have recognised that they need to be more responsive to the mental health needs of people with learning disabilities. As a learning disability nurse wishing to ascertain the effectiveness of CBT as a practical intervention when presented with the dual-diagnosis of anxiety disorder and learning disability, is through the use of 'evidence-based practice'.

When deciding on the best possible clinical intervention for an identified practice problem it seams logical to convert the issue into a single answerable question