Lost in the system: rethinking mainstream mental health services for people with intellectual disabilities

People with intellectual disabilities face significant barriers to accessing mental health services despite high rates of co-occurring conditions. Diagnostic overshadowing, limited clinician training, and rigid service models contribute to exclusion and poor outcomes. While evidence-based therapies like adapted cognitive behavioural therapy show promise, they are rarely implemented consistently. Integrated care models that coordinate health and social care offer useful examples; however, a specific standard of good practice in the literature is sparse. Inclusive service design involving people with lived experience is urgently needed. To improve access and outcomes, mental health services must embed intellectual disabilities competencies, inform service policy, and ensure accountability. Future research should focus on long-term effectiveness and user-centred interventions.