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Impact of care pathway-based approach on outcomes in a specialist intellectual disability inpatient unit
- Authors:
- DEVAPRIAM John, et al
- Journal article citation:
- Journal of Intellectual Disabilities, 18(3), 2014, pp.211-220.
- Publisher:
- Sage
- Place of publication:
- London
Specialist intellectual disability inpatient units have come under increased scrutiny, leading to questions about the quality of service provision in this sector. A care pathway-based approach was implemented in such a unit and its impact on outcome variables was measured. The care pathway-based approach resulted in the turnover of more patients, increased capacity for admissions to the unit, reduced lengths of stay in hospital, timely assessments and treatments, which resulted in better outcomes in patients. Care pathway-based approach to service provision provides not only better outcomes in patients but also a reliable way of ensuring true multi-agency working and accountability. If used widely, it can reduce the variability in the quality of current service provision. (Publisher abstract)
Tiered model of learning disability forensic service provision
- Authors:
- DEVAPRIAM John, ALEXANDER Regi T.
- Journal article citation:
- Journal of Learning Disabilities and Offending Behaviour, 3(4), 2012, pp.175-185.
- Publisher:
- Emerald
Traditionally, services for people with learning disabilities (LD) and forensic needs are underdeveloped. This paper aims to describe the setting up of a tiered model of LD forensic service provision in Leicester, Leicestershire and Rutland, facilitated and driven by a core team of professionals who have the skills and expertise in this area. With no dedicated funding, this team is virtual in nature and provides support for the community and in-patient teams in the assessment and management of offenders with LD. A care pathway including a process map is included to represent a visual idea of the referral, assessment, intervention and disposal strategies across the four tiers of service delivery. The service has a unique partnership arrangement with the independent sector that allows for staff training in order to deliver quality outcomes. The virtual team can support patients with learning disabilities and forensic needs in the community and in-patient settings, both by avoiding unnecessary in-patient admissions and by improving the treatment outcomes of those discharged from in-patient settings. Further research is required to demonstrate the clinical and social outcomes for offenders with LD using the tiered model of care and care-pathway. (Edited publisher abstract)
A comparative study of stress and unmet needs in carers of South Asian and white adults with learning disabilities
- Authors:
- DEVAPRIAM John, et al
- Journal article citation:
- Ethnicity and Inequalities in Health and Social Care, 1(2), December 2008, pp.35-43.
- Publisher:
- Emerald
A sample of 742 informal carers was selected from the Leicestershire Learning Disability Register. Data on carers' and subjects' demographic details, stress levels and unmet service needs were analysed and compared using chi-square tests and logistic regression analyses. Substantial differences were observed between the two groups. Carers of South Asian adults with learning disabilities reported significantly higher levels of care provision and unmet needs. Major stress was reported in 23% of carers. This was more common in carers with poor health, in those caring for younger adults, carers of adults with psychological symptoms, and in those with an expressed need for moral support or respite care. Stress is common among informal carers of adults with learning disabilities and inequalities, in reported care given and unmet needs, exist between carers of South Asian and white adults. Practitioners need to be aware of factors associated with stress when assessing carers in this population.
Arson: characteristics and predisposing factors in offenders with intellectual disabilities
- Authors:
- DEVAPRIAM John, et al
- Journal article citation:
- British Journal of Forensic Practice, 9(4), December 2007, pp.23-27.
- Publisher:
- Emerald
This retrospective study focuses on examining the characteristics of offenders with intellectual disabilities (ID) and the range of identified reasons for the offence. The study population consisted of 1,100 patients with ID who were in contact with psychiatric services at the Leicestershire Frith Hospital. Fifteen patients were identified as having committed arson. The findings indicate a higher prevalence of arson in this population, along with the fact that the majority of people with ID who have committed arson tend to bypass the criminal justice system. A significant number are likely to repeat the behaviour and will also commit other offences. The most common reason for arson appears to be revenge, closely followed by suggestibility. The majority has an associated diagnosis of personality disorders along with Axis 1 psychiatric diagnosis. Other factors include large family size, history of childhood psychiatric disorders, abuse, homelessness, unemployment and relationship difficulties.