Mackin et al (Reference Mackin, Bishop and Watkinson2007) highlight the importance of screening and management of metabolic syndrome in patients with severe mental illness. This is particularly important in patients with intellectual disability as they have high rates of both physical and psychiatric comorbidities compared with the general population (Welsh Office, 1996). In addition, considerable evidence points to a disparity between the health of people with learning disability and the general population, and this was also highlighted in two Mencap reports (Mencap, 2004, 2007).

Suggested causes for this disparity include specific patterns of complex health needs associated with the aetiology of their intellectual disability, sensory and communication difficulties, reliance on carers to communicate their health needs, and barriers to healthcare accessibility due to poor professional knowledge and attitudes.

The Government White Paper Valuing People (Department of Health, 2001) acknowledges this disparity and identifies the improved healthcare of people with intellectual disability as a key outcome. However, the document is a little unclear on how these aims will be achieved.

As Mackin et al point out few studies specifically examine the impact of different models of care on physical well-being and comorbidities in people with severe mental illness, and this is also the case for people with intellectual disability. There is a pressing need for evidence-based integrated models of care for delivering high standards of care for this patient group.