EDITORIAL

EDITORIAL Dorothy Atkinson and Jan Walmsley Welcome to the ®rst issue of the journal in 2001. To mark the start of the new year, and a new volume, we introduce a new series of Ìn conversation' articles. We are delighted that the ®rst of the series features a conversation with John Hutton, Minister of State for Health. There will be other conversations with key people throughout this year. This is one way in which we can stay abreast of events, and feature items of topical interest. There is a sense in which Andrew Holman's conversation with John Hutton is both topical and historical. It is topical because it features the Government's learning disability strategy and the White Paper which will give it `real clout'. The need for a new strategy became apparent in the ®rst place, according to the Minister, through listening to people with learning disabilities and the strategy has been devised with their direct involvement. The article makes the point that: ``Never before have so many people with learning dif®culties been involved in the making of Government policy.'' This article also has an historical theme. The last White Paper was 30 years ago and was, in its time, an in¯uential document that marked the beginning of the shift from insti- tutional to community care. Thirty years on, that shift is yet to be completed. Similarly, the move to inclusive education which, according to Ian Copeland, began in the late 19th century, is also incomplete. Copeland's paper, Ìntegration vs. segregation', looks back at the ®rst educational provision for children who were considered ``dull, backward and defective'' at the end of the 19th century. In his historical research, Copeland discovered an early example of integrated education in Leicester. Alongside this integrated approach was the drive for special schools, especially in London. The number of special schools grew rapidly after the ®rst one was opened in 1892. Other education authorities followed suit. The struggle for integration, traced back to Leicester in the 19th century is not over ± the inclusive education movement of today is still working towards that goal. The struggle for integration, or inclusion, of people with learning disabilities does not necessarily end, however, with providing opportunities for their participation in an òrdin- ary life'. Two papers take up key issues around the mean- ingful involvement of people with learning disabilities in decisions affecting their lives. Involvement requires communication ± but how do people with severe learning disabilities communicate their wishes and needs? And who interprets their `communication behaviours'? In their paper, Ìnterpret- ing the communication of people with profound and multi- ple learning dif®culties', Jill Porter, Carol Ouvry, Maggie Morgan and Caroline Downs argue that it is the people closest to the person with severe learning disabilities who interpret their everyday wishes and needs, but may do so on the basis of inference. The authors argue for ®nding ways of validating communication, in particular through working with family and others to share information and build up a communication pro®le. The theme of involvement is taken up by Michelle Alexander and John Hegarty, in their paper `Measuring client participation in individual programme planning meetings'. They argue that it is important for people with learning disabilities to be involved in the process of planning for their future, but attendance at a meeting by no means guarantees that people can participate in it. The authors describe how they devised an IPP participation checklist to assess the participation of ``Mr B'' in his meeting, and in particular to note where he did not participate, with the aim of encouraging staff to support his greater participation in the future. The last two papers deal with the important topic of how to work most effectively with people with learning disabilities who are experiencing mental health problems. They reach very different conclusions. The paper by Henry Kwok describes a specialized psychiatric service for people with learning disabilities that was developed in a psychiatric Hospital in Hong Kong. The author suggests that psychiatric problems and challenging behaviours are ``com- mon complications of learning disabilities'' and can prevent people from leading a normal life. The special mental health needs of people with learning disabilities, it is argued, need a special multidisciplinary setting where an accurate diagnosis can be made, and special treatment given. The ®nal paper in this collection takes a very different line. Biza Stenfort Kroese, Damian Dewhurst and Guy Holmes, in their paper, `Diagnosis and drugs', question the usefulness of psychiatric diagnosis and psychotropic medication in alle- viating psychological problems experienced by people with learning disabilities. They question the current over-pre- scribing of psychotropic medication, particularly its use as a ``chemical restraint'' and recommend, at the very least, the # 2001 Blackwell Science Ltd, British Journal of Learning Disabilities, 29, 1±2 1

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