17 General Introduction 1 borderline intellectual functioning’, the target group is referred to as ‘mild intellectual disability’ throughout this dissertation. This is done to improve readability, but please bear in mind that, formally speaking, those with borderline intellectual functioning are included. Prevalence rates People with a mild intellectual disability constitute a significant portion of the Dutch mental healthcare system. Under the current definition of a mild intellectual disability, a roughly estimated 1.1 million Dutch people have a mild intellectual disability. Of course, not all are diagnosed as such, nor do this many people receive care specialized youth or adult mental healthcare for it. In the Netherlands, youth care is possible until the maximum age of 23. Adult mental healthcare facilities, some of which are also specialized for mild intellectual disability, are available for ages 18 and above. Approximately 110,000 people have a formal diagnosis and receive a form of (specialized) ambulatory or residential mental healthcare for people with disabilities ("Wet Langdurige Zorg"; CBS, 2020). Approximately 2,000 Dutch youth with a mild intellectual disability receive intensive residential care for their severe behavioral problems in the so-called “Orthopedagogische Behandelcentra” (Buysse et al., 2021). Also in regular youth care facilities, where a total of approximately 479,000 youth receive care, those with a mild intellectual disability diagnosis are overrepresented (CBS, 2024). That is, whereas 0.5% of youth who are not in youth care are diagnosed with a mild intellectual disability, this relative percentage is higher within the population that receives ambulatory youth care (1.4%). Especially in residential youth care, which includes open, semi-secure, and secure facilities (Harder et al., 2006), the overrepresentation of youngsters with a mild intellectual disability is most apparent (7.6%). Similar to their overrepresentation in youth care, there are disproportionally many adults with a mild intellectual disability in psychiatric care. Recent screening by Nieuwenhuis et al. (2022) showed that a staggering 44% of people in regular Dutch psychiatric care meet the criteria for a mild intellectual disability, suggesting that roughly 64,000 people could profit from specialized care for mild intellectual disability. Taken together, these prevalence rates indicate that the target group takes up a large part of the mental healthcare system. “Common” problems Young people with a mild intellectual disability often face a range of challenges that can manifest as behavioral problems. It can be overwhelming to process information, organize thoughts, and complete tasks, leading to a sense of failure that may manifest in disruptive behaviors. Many of them struggle with regulating
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