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Clinical psychopathology, untoward incidents and the use of restrictive procedures in adults with intellectual disability
- Author:
- CHAPLIN Eddie
- Journal article citation:
- Journal of Applied Research in Intellectual Disabilities, 22(2), March 2009, pp.169-178.
- Publisher:
- Wiley
The authors examined all untoward incidents (n = 397) that were recorded for a group of service users (n = 65) referred to a specialist unit for adults with intellectual disability over a 6-year period. Associations between different restrictive procedures and clinical psychopathology were investigated. Physical assault was the most common incident associated with physical restraint, male gender and presence of autism. De-escalation was the most frequently employed intervention associated with less serious incidents such as verbal abuse and theft. Specific interventions seem to be associated with different types of incidents and presence of autism. The results are discussed in terms of clinical practice and possible future directions.
Better services for people with an autistic spectrum disorder
- Author:
- CHAPLIN Eddie
- Journal article citation:
- Advances in Mental Health and Learning Disabilities, 1(4), December 2007, pp.27-28.
- Publisher:
- Emerald
The author provides a critical commentary of 'Better Services for People with an Autistic Spectrum Disorder', published by the Department of Health in 2006. The document sought to clarify the nature and intent of current government policies and to encourage local health and social care providers to develop 'local agendas for action' in ensuring its implementation.
A systematic review of the effectiveness of psychological approaches in the treatment of sex offenders with intellectual disabilities
- Authors:
- JONES Emma, CHAPLIN Eddie
- Journal article citation:
- Journal of Applied Research in Intellectual Disabilities, 33(1), 2020, pp.79-100.
- Publisher:
- Wiley
Background: Despite considerable advance and growth in the evidence base for psychological interventions as treatment for sex offenders with intellectual disabilities (ID), there remains limited evidence to support their effectiveness. This systematic review seeks to evaluate the effectiveness of psychological interventions on reducing reoffending rates for sex offenders with ID. Methods: A search of ten electronic databases, grey literature and reference lists was conducted using PRISMA methodology. Results: A number of studies appeared to establish positive treatment outcomes, demonstrated by improvements in attitudinal change, victim empathy and sexual knowledge. However, reductions in sexual reoffending during the follow‐up period were not consistent across the studies. No studies with an adequate control comparison were identified during the search. Conclusions: The current review provides limited evidence on the effectiveness of psychological interventions for sex offenders with ID, while also highlighting the need for further research. (Publisher abstract)
Does substance use predict contact with the criminal justice system for people with intellectual disabilities?
- Authors:
- CHAPLIN Eddie, et al
- Journal article citation:
- Journal of Intellectual Disabilities and Offending Behaviour, 5(3), 2014, pp.147-153.
- Publisher:
- Emerald
Purpose: The purpose of this paper is to examine how substances misuse impacts on exposure to the criminal justice system for people with intellectual disabilities (ID). Design/methodology/approach: An electronic case-register of mental health patients was used to examine the clinical records of 411 patients with ID. χ2 analysis was performed to test the association between variables and logistic regression to generate estimates for statistically significant association variables. Findings: Of 411 cases, 98 (23 per cent) of patient had a history of substance use, with affective disorders strongly associated with alcohol misuse χ2=4.135, df=1 (p<0.042), similarly statistically significant predictor for alcohol misuse OR: 1.7, 95 per cent CI (1.02-2.72) (p<0.043). Patients with a history of offending behaviour had three-folds higher risk to misuse drugs compared to those without a forensic conviction OR: 3.17, 95 per cent CI (1.35-7.44) (p<0.008). Those with a history of offending were more likely to have had a history of substance use. Originality/value: Substance use and its impact on offending by people with ID is still poorly understood. This paper adds new information to this under researched area. (Publisher abstract)
Autism spectrum disorders and offending
- Authors:
- GUNASEKARAN Santhana, CHAPLIN Eddie
- Journal article citation:
- Advances in Mental Health and Intellectual Disabilities, 6(6), 2012, pp.308-313.
- Publisher:
- Emerald
The authors provide a general review of offending and autism spectrum disorders from their own perspectives as practitioners, as portrayed in the media, and as evidenced in the research base. The review suggests that the strength of the association between autistic spectrum disorders and offending is not as high as that established for psychotic illness and violence. Among the subgroups within the spectrum those with lower cognitive ability appear to have lower prevalence of offending compared to the general population. The strength of the association with violence is not significantly greater compared to the general population among other subgroups (high functioning/Asperger’s and atypical autism). Comorbidity may increase the risk of an association with violence. Association with illicit drugs and/or alcohol is less common than for the population at large. The authors conclude that there are differences in the characteristics of offences and motivation for offending across the spectrum. They stress the need to avoid stereotyping of offending with autism spectrum disorders.
England and Northern Ireland policy and law update relating to mental health and intellectual disability
- Authors:
- CHAPLIN Eddie, TAGGART Laurence
- Journal article citation:
- Advances in Mental Health and Intellectual Disabilities, 6(3), 2012, pp.144-150.
- Publisher:
- Emerald
Two years ago this journal presented overviews and perspectives from across the UK relating to mental health and intellectual disability. This article aims to bring readers up to date with policy developments and current issues in England and Northern Ireland. As well as looking at changes to policy and legislation, the paper highlights the differences and shared concerns for people with intellectual disability living in the two countries, for example access to equitable health care. The review found that, in spite of shared visions of inclusion and equality in mental health care, there are major differences in how the countries approach these issues. This has been emphasised by recent shifts in policy. In Northern Ireland strategies are being designed to inform the delivery of evidence based services for the future while in England there has also been a move towards public protection within mental health legislation and the reaffirmation of the need to for more individualised services. It is concluded that although there is a desire for change, the reality is that the policies and legislation introduced to address issues such as accessing mental health care and service standards have still to make a significant impact to people's daily lives.
Improving services through partnership and consultation: a case example
- Authors:
- CHAPLIN Eddie, et al
- Journal article citation:
- Advances in Mental Health and Intellectual Disabilities, 5(2), March 2011, pp.3-8.
- Publisher:
- Emerald
A process of monitoring and auditing care quality is integral to modern health service delivery in order to improve standards and to ensure patient safety and welfare. This paper describes how, following an audit, a specialist mental health assessment and treatment inpatient service for people with intellectual disabilities put in place a process to improve and reprovide the service in partnership with local stakeholders. Concerns were raised by an audit of training and staffing which reported a catastrophic fall in staffing and concluded that without intervention there would be a danger that the service would be unable to provide an acceptable level of service. This paper describes the response to this audit, including the temporary measures that were put in place and the development of a permanent solution. In describing the process the paper highlights the need for transparent and honest working relationships with stakeholders, along with the role of audit and monitoring of quality to determine the health and effectiveness of services. This includes evaluating the continuing need for service and maintaining an agenda driven by needs rather than beds, based on best practice.
Using a simulation exercise to develop staff competence in a specialist inpatient service
- Authors:
- HARDY Steve, CHAPLIN Eddie
- Journal article citation:
- Advances in Mental Health and Intellectual Disabilities, 4(4), December 2010, pp.35-39.
- Publisher:
- Emerald
This case report provides a description of a simulation exercise as part of the induction programme for a staff team recruited to a specialist inpatient service for adults with intellectual disabilities and additional mental health problems. The idea of the simulation exercise was to provide a range of clinical scenarios in the physical environment in which the team would actually be working. A list of common needs of patients and other issues was developed to ensure they were included in the simulation. Professional actors were used to play the parts of the patients. The simulation exercise was held over the course of a day, and was separated into 2 shifts. A debriefing session was held immediately after both shifts had been completed, including observations from the facilitators and actors and an overview of the individual observers’ comments. This article describes the rationale for this novel approach, along with details of its planning, implementation and outcomes.
People with learning disabilities placed out of area: the South London experience
- Authors:
- CHAPLIN Eddie, et al
- Journal article citation:
- Journal of Learning Disabilities and Offending Behaviour, 1(3), October 2010, pp.5-14.
- Publisher:
- Emerald
One of the consequences of the closure of long-stay NHS hospitals has been the placement of people with learning disabilities who offend or have offending-type behaviours ‘out of area’ many miles from local services. This move of people out of area has made it difficult in many localities to develop local services and to monitor the quality of care for this group. This paper describes the start of an exercise to examine potential local care pathways for those who present with offending behaviours and to look at differences between the out of area group, and another receiving treatment locally. The first phase of the study comprised collecting numbers, type of placements, and clinical characteristics of service users placed out of area. The second phase consisted of interviews with service users in order to compare functioning, behaviour problems, need and quality of life of 28 participants placed out of area with 27 participants treated locally. Within the two groups the study found no significant differences regarding rates of psychiatric disorder, quality of life, or levels of unmet need. The main difference was that the out of area group was largely characterised by a range of aggressive and challenging behaviour, necessitating the additional structure and securities provided by out of area placements.
Barriers to user involvement in mental health services for people with learning disability
- Authors:
- CHAPLIN Eddie, et al
- Journal article citation:
- Advances in Mental Health and Learning Disabilities, 3(3), September 2009, pp.28-33.
- Publisher:
- Emerald
This paper explores some of the issues and barriers to service user involvement for people with learning disability in mental health settings. The barriers can include staff perceptions and their moral and religious beliefs, and can also include the culture and policies of the mental health organisation. Service users may also not welcome involvement in their own care. The issues of getting users involved in their own assessment and treatment is addressed, as is also getting them involved with services and the wider health community. Examples of good practice, such as service user groups, are provided.