Search results for ‘Subject term:"learning disabilities"’ Sort:
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Secure inpatient services: a needs assessment
- Authors:
- HALL Ian, et al
- Journal article citation:
- Journal of Intellectual Disabilities and Offending Behaviour, 5(1), 2014, pp.38-53.
- Publisher:
- Emerald
Purpose: The purpose of this paper is to complete a thorough needs assessment that would enable the development of a robust pathway of care for adults with a learning disability requiring secure care, and to assist commissioners to make informed planning decisions. Design/methodology/approach: The paper identified people with a learning disability originating from London who were in secure care, and collected data about them. The paper used reference groups to inform the analysis. Findings: The paper identified 249 people in secure services and was able to include 136 patients in the analysis. In all, 64 were in NHS provision and 72 in independent sector provision; 109 (80.1 per cent) were male and 27 (19.9 per cent) female; on average, patients were cared for 61.5 miles away from their homes; NHS patients were far closer to home; 69.1 per cent had a mild learning disability; 82.3 per cent had a history of violence; approximately one in six patients could not progress due to a lack of an appropriate ward, facility, resource and/or intervention. Practical implications: Secure care for this population is a major public health issue. Many are placed a long way from home. Local services should be developed, and there should be sufficiently robust “step down” places for patients to be discharged to. Originality/value: Systematic identification of the needs of a marginalised group to enable better more appropriate care pathways to be developed in the future. (Publisher abstract)
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.
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.
Making care programme approach meetings more accessible and person-centred for people with learning disabilities
- Authors:
- HALL Ian, et al
- Journal article citation:
- Advances in Mental Health and Learning Disabilities, 3(1), March 2009, pp.23-29.
- Publisher:
- Emerald
The care programme approach (CPA) is an important part of supporting people with mental health problems in the community and has been applied with variable success in services for people with learning disabilities. Investigation into service users' understanding of the CPA has been limited. This study employed multiple methodologies to explore what service users with learning disabilities and additional mental health problems thought about the CPA process, and what their understanding of it was. The authors used the findings to work with other professionals to adapt the meetings in a way that was accessible and inclusive. This work was included in the service communication plan and produced guidance for care co-ordinators and materials to be used at the meetings. The guidance and materials can be used by any service and will be available online.
Cross dressing and gender dysphoria in people with learning disabilities: a descriptive study
- Authors:
- PARKES Georgina, HALL Ian, WILSON Daniel
- Journal article citation:
- British Journal of Learning Disabilities, 37(2), June 2009, pp.151-156.
- Publisher:
- Wiley
The authors aimed to determine the characteristics of people with learning disability who cross-dress or who have gender dysphoria. they carried out a retrospective review of anonymised data from clinical records about people referred to a specialist service. All 13 participants cross-dressed and 12 were biological males. Only one person was in a core transsexual group which may do better from sex reassignment surgery. There was a high level of mental health problems and high levels of reported childhood abuse. Three people were unhappy about their homosexual feelings, and two people had capacity issues. People with learning disabilities experience a wide range of gender identity issues similar to those seen in the non-learning disabled population. They would benefit from a more person centred understanding. People with learning disability may need longer assessments and more psychotherapeutic exploration and intervention prior to thinking about hormone and surgical interventions. Deciding treatment in someone's best interests for those lacking capacity presents complex ethical dilemmas.