Psychiatry of intellectual disability (PID)

Psychiatrists of lntellectual disability (PID) are specialist psychiatrists who offer psychiatric treatment for those with intellectual disabilities. They also treat other conditions including autistic spectrum disorders, other neuro-developmental disorders and epilepsy.

This page provides useful information on the nature of the work, the common procedures/interventions, sub-specialties and other roles that may interest you.

Nature of the work

People with intellectual disability have higher rates of mental health problems than the general population. Their biological and psychosocial risk factors are often greater and they may also have fewer internal resources to cope with mental distress, making them vulnerable. Minor disorders can sometimes have a severe effect for those with an intellectual disability, resulting in more psychiatric referrals.

Most intellectual disability psychiatrists see patients from the age of 18 upwards. Younger patients may be seen by child and adolescent psychiatrists or sometimes intellectual disability psychiatrists who specialise in work with children.

Psychiatrists working in this field need a wide range of clinical skills. The work is often made more complex and interesting by associated physical problems such as epilepsy and cerebral palsy, along with sensory and communication problems and challenges in accessing services. 

Patients may present non-specifically (for example with withdrawal or change in behaviours) and finding out the cause is a fascinating diagnostic challenge. Anxiety disorders and obsessive compulsive disorders are common, as well as behaviours that challenge. Other psychiatric conditions including depression, bipolar disorder and schizophrenia are also diagnosed more frequently than in the general population.

Intellectual disability psychiatrists work as part of multidisciplinary teams providing mutual support. It is also important to work closely with family members and carers to help understand clinical problems and deliver effective interventions. The psychiatrist will often lead the team and provide support and advice.

Psychiatry of intellectual disability is an interesting academic discipline, whether you are interested in the biological basis of mental health problems (e.g. dementia in people with Down’s syndrome, behavioural phenotypes of genetic disorders), or the development of innovative service models.

Much work has been done in recent years in applying psychotherapeutic and systemic approaches to working with people with intellectual disability. There are also several high profile academic centres around the country offering research opportunities.

Common procedures/interventions

Supported living and person-centred planning are key to intellectual disability psychiatry and have brought substantial improvements to people’s quality of life.

Most specialist mental healthcare for people with intellectual disability is delivered in community settings. Mainstream beds are routinely used for those with mild intellectual disability and mental health problems who are able to access and in need of inpatient admission. Specialist inpatient facilities are provided for people with forensic needs, and those with a significant intellectual disability and challenging behaviour.

A wide variety of tailored treatments are available, as in mainstream psychiatry, including pharmacological intervention, psychological interventions (including behavioural therapy) social and educational interventions.


Within the specialty there are further subspecialties including child and adolescent and forensic.

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