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Low security: patient characteristics which lead to an offer of admission and staff perceptions in a unit for people with intellectual disability
- Author:
- YACOUB Evan
- Journal article citation:
- Advances in Mental Health and Intellectual Disabilities, 4(4), December 2010, pp.25-34.
- Publisher:
- Emerald
This paper focuses on the characteristics of patients with intellectual disabilities offered an admission to a low secure intellectual disability unit, and staff views of low security settings for people with intellectual disabilities. The project was based at a low secure NHS unit for people with intellectual disabilities which accepts referrals from regions within the M25. A case-controlled study was carried out for 33 patients referred to the unit over 42 months. The characteristics of 18 patients offered an admission were compared with those of 15 patients not offered an admission. In addition, 5 of the staff working on the unit were interviewed about the concept of low security. The findings showed that patients offered an admission were more able than those not offered an admission, posed more risks and were more complex diagnostically. Staff working on the unit agreed that their patients were complex, but felt that they were appropriately placed overall. The challenges of low secure provision were discussed by staff. Patients sampled were complex and heterogeneous, but not necessarily ‘forensic’, and their complexity requires sophisticated care plans and management strategies.
Impact of challenging behaviour on siblings of people with autism
- Authors:
- YACOUB Evan, et al
- Journal article citation:
- Advances in Mental Health and Intellectual Disabilities, 12(5-6), 2018, pp.145-152.
- Publisher:
- Emerald
Purpose: Despite being largely supportive of their sibling with an autism spectrum disorder (ASD), some siblings without ASD also feel the effects of the disorder particularly in relation to challenging behaviour and lack of empathy. The purpose of this paper is to explore the experiences adults who have a sibling with ASD and intellectual disability (ID) with challenging behaviour. Design/methodology/approach: Interviews were conducted with 11 capacitous adult siblings of service users who have ASD and ID as well as a history of challenging behaviour. A modified version of the autism Parenting Stress Index was used to assess the impact on those siblings. thematic analysis was utilised to analyse their responses. Findings: Four main themes emerged from the interviews, which highlighted that challenging behaviour can cause emotional losses and can impact upbringing and the sibling relationship. Despite the siblings making adjustments, they continue to have concerns for the future. Originality/value: Chronic challenging behaviour can impact on siblings, and it is important to support entire families, and not exclusively parents. (Edited publisher abstract)
Assessing risk in services for people with intellectual disability
- Authors:
- YACOUB Evan, LATHAM Richard
- Journal article citation:
- Advances in Mental Health and Intellectual Disabilities, 6(6), 2012, pp.301-307.
- Publisher:
- Emerald
The authors make recommendations for practitioners on risk assessment, particularly with regard to violence and aggression, in relation to people with intellectual disability. They summarise research in the area with the aim outlining a practical approach for practitioners. It is suggested that risk assessment for the purpose of predicting risk in an individual is not likely to be of value in clinical settings; it is not an exact science. The use of structured clinical judgement does however provide a comprehensive structure for considering relevant risk factors, developing an overall formulation relating to a specific risk and devising a risk management plan. It is advocated as a useful tool for developing a risk management plan for practitioners working with people with intellectual disability in secure and community settings. The authors note that much of the existing evidence is extrapolated from research with people without an intellectual disability.
The sexual lives of men with mild learning disability: a qualitative study
- Authors:
- YACOUB Evan, HALL Ian
- Journal article citation:
- British Journal of Learning Disabilities, 37(1), March 2009, pp.5-11.
- Publisher:
- Wiley
This study aimed to explore the sexual lives and behaviour of men with mild learning disabilities living both in community and in secure hospital settings. Narrative interviews that focused on areas such as relationships, sex education, contraception and the attitudes of others towards the participants' sexual lives and orientation were used. Several clients reported engaging in unsafe practices despite being aware of the risks. Participants generally felt that services had shifted from a paternalistic to a more supportive approach towards their sexual lives and orientation. Experiences with other men were commonly reported. Several participants reported being pressurised into sex as adults. In the sample, sexual knowledge did not lead to safe sexual practices. The good rapport with services reported by the participants may be utilised to provide further education and empowerment to improve the safety of sexual practices in this group. Other ways of improved service delivery are suggested.
Sex, relationships and the law for people with learning disability
- Authors:
- HALL Ian, YACOUB Evan
- Journal article citation:
- Advances in Mental Health and Learning Disabilities, 2(2), June 2008, pp.19-24.
- Publisher:
- Emerald
This article reviews the policy, legislation and literature on sex and relationships for people with learning disability, through a search of electronic databases, journals and other resources. It reviews the rights of people with learning disabilities to a sexual life and their views of service responses, sexual offences legislation and the link between sexual knowledge and practice. It also explores sexual orientation and preference among people with learning disabilities, differences between the genders and sexual offending, including consideration of 'victimless' offences. It concludes that the balance between empowering and protecting people with learning disabilities is challenging but important.
Secure inpatient services for people with intellectual disability: lessons from developing a new service
- Authors:
- HALL Ian, YACOUB Evan, YUSUFI Babur
- Journal article citation:
- Advances in Mental Health and Intellectual Disabilities, 4(4), December 2010, pp.15-24.
- Publisher:
- Emerald
Secure inpatient services for people with intellectual disability are provided in a piecemeal way, often without strategic commissioning. Such people are often placed in remote and costly units because suitable local facilities do not exist. This article describes the development of a new secure inpatient service led by the local NHS foundation trust for men with intellectual disability who often had substantial additional mental health needs. In particular, the article describes the needs assessment of 27 people using specialist inpatient services who originated from the local service area, which comprised 4 inner London boroughs. Consulting with all stakeholders was found to be essential, with the service user and family perspectives particularly helpful. The finding of this service development project were: that foundation trusts that are able to develop services at financial risk, before contracts are signed, enabled development to take place at a faster pace; good relationships with community teams are essential, as is true integration with mainstream forensic services; and maintaining a relationship with commissioners was a particularly challenging aspect, perhaps because the development was provider-led. Despite these challenges, the new service has enabled many people with intellectual disability with very high needs to be supported much nearer to home.
Secure in-patient services for people with learning disability: is the market serving the user well?
- Authors:
- YACOUB Evan, HALL Ian, BERNAL Jane
- Journal article citation:
- Psychiatric Bulletin, 32(6), June 2008, pp.205-207.
- Publisher:
- Royal College of Psychiatrists
Psychiatrists can help in the development of better local services for people with learning disability by clearly defining the client group and their needs, involvement in the process of commissioning such services, and learning from colleagues in other service areas such as forensic psychiatry. This should help enable people with learning disability with very high needs to have similar access to services as others have.