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Broken systems broken lives: 11 policies to limit ATU admissions and accelerate discharges
- Author:
- DIMENSIONS
- Publisher:
- Dimensions
- Publication year:
- 2022
- Pagination:
- 10
- Place of publication:
- Reading
This briefing sets out 11 policy proposals to limit ATU (Assessment and Treatment Unit) admissions and accelerate discharges. The number of people in an ATU with a learning disability has almost halved, yet the number of those with an autism-only diagnosis has increased dramatically. Now: 6 out of every 7 people under the age of 18 admitted to ATUs have autism and no learning disability; if you have an autism-only diagnosis in an ATU, you are far less likely to have a discharge plan in place than if you have a learning disability (22% vs 30%); the proportion of inpatients with an autism-only diagnosis has risen from 16% to 34% in the past 6 years. The proposed policies include: fix the numerous perverse financial disincentives to discharge; fund social care in line with the Local Government Association's (or similar) assessment of need; no ATU should be able to score better than inadequate in a CQC inspection if more than 10% of patients are missing an in-date CTR (Care and Treatment Review); no ATU should be able to score better than inadequate in a CQC inspection if more than 10% of an inspected sample are considered to fail quality parameters; every CTR must identify locally present organisations with experience of supporting people out of ATUs; an outright ban on for-profit organisations running ATUs; strengthen family information networks through funding independent advocacy groups; increase funding to the Disabled Facilities Grant; commit funds to specialist housing development in line with forecast long term demand; require a proportion of 'social housing. in mainstream developments to include restricted funding for alterations to meet individual accessibility requirements Accountability and progress; create a new role - National Director for Transforming Care. (Edited publisher abstract)
MIETS: a service option for people with mild mental handicaps and challenging behaviour or psychiatric problems. 1: Philosophy, service, and service users
- Authors:
- MURPHY G., et al
- Journal article citation:
- Mental Handicap Research, 4(1), 1991, pp.41-66.
- Publisher:
- BIMH Publications
Explains how the Mental Impairment Evaluation and Treatment Service operates, the referral and assessment procedures, and evaluation of quality of life.
Team formulation in an assessment and treatment unit for individuals with learning disabilities: an evaluation through staff views
- Authors:
- TURNER Kellie, CLEAVES Lydia, GREEN Samantha
- Journal article citation:
- British Journal of Learning Disabilities, 46(4), 2018, pp.278-283.
- Publisher:
- Wiley
Background: Research suggests that the use of team formulation within mental health services may improve staff understanding of service users’ difficulties and increase team empathy and reflection. The aim of this evaluation was to investigate staff perceptions of team formulation within an assessment and treatment unit for individuals with learning disabilities. Specifically, the authors aimed to investigate whether staff found team formulation helpful and whether staff felt it impacted their work with service users. Materials and Methods: A survey was completed using a cross‐sectional questionnaire design. Twenty‐eight staff members working on the assessment and treatment unit were asked to complete an anonymous questionnaire about team formulation meetings. Results: The response rate was 54%. The majority of staff agreed that they found formulation meetings to be helpful (80%) and that formulation meetings positively impacted how they work with service users (86%). The most common theme arising from staff responses concerning the most helpful aspects of formulation meetings was “gaining a greater understanding of service users.” Conclusions: The findings from this evaluation show that the majority of respondents felt team formulation was helpful and had a positive impact on their work with service users. These findings support the use of team formulation within mental health and learning disabilities services. Future research could investigate the impact of team formulation on service user well‐being and outcomes. (Publisher abstract)
People with intellectual disabilities accessing mainstream mental health services: some facts, features and professional considerations
- Authors:
- STANDEN Penelope Jane, CLIFFORD Adam, JEENKERI Kiran
- Journal article citation:
- Journal of Mental Health Training Education and Practice, 12(4), 2017, pp.215-223.
- Publisher:
- Emerald
Purpose: The purpose of this paper is to provide information for non-specialists on identifying the characteristics, assessment and support needs of people with intellectual disabilities (ID) accessing mainstream services. Design/methodology/approach: A review of relevant policy and research literature is supplemented with observations from the authors’ own experience of working in mental health services for people with ID. Findings: With change in provision of services the likelihood of mainstream staff encountering someone with ID will increase. However, information on whether a person has ID or their level of ID is not always available to professionals in acute mental health services meeting an individual for the first time. Reliance on observational and interview-based assessments can leave people with ID vulnerable to a range of over- and under-diagnosis issues. This is as a result of difficulties with communication and emotional introspection, psychosocial masking, suggestibility, confabulation and acquiescence. For people with poor communication, carers will be the primary source of information and their contribution has to be taken into account. Practical implications: Knowing or suspecting an individual has ID allows staff to take into account the various assessment, diagnosis and formulation issues that complicate a valid and reliable understanding of their mental health needs. Awareness about an individual’s ID also allows professionals to be vigilant to their own biases, where issues of diagnostic overshadowing or cognitive disintegration may be important considerations. However, understanding some of the practical and conceptual issues should ensure a cautious and critical approach to diagnosing, formulating and addressing this population’s mental health needs. Originality/value: This synthesis of a review of the literature and observations from the authors’ experience of working in mental health services for people with ID provides an informed and practical briefing for those encountering people with ID accessing mainstream services. (Publisher abstract)
How can mental health clinicians, working in intellectual disability services, meet the spiritual needs of their service users?
- Authors:
- LOYNES Benjamin, O'HARA Jean
- Journal article citation:
- Advances in Mental Health and Intellectual Disabilities, 9(1), 2015, pp.9-18.
- Publisher:
- Emerald
Purpose: The purpose of this paper is to identify approaches that mental health clinicians, working in intellectual disability services, can adopt to ensure the spiritual needs of their service users are met. Design/methodology/approach: A narrative literature review examining original research, expert opinion pieces and book chapters was undertaken. To broaden the perspective of the paper, publications from different academic areas were reviewed including intellectual disabilities, mental health, neurodevelopmental disorders, general health and spirituality literature. Findings: The main principles of spiritual assessment tools from the general health literature can be applied to this group. However, the literature would suggest that certain approaches are of particular importance in intellectual disabilities mental health including advocating for service users to attend the religious services they wish to and working collaboratively with families and carers when addressing spiritual issues. Research limitations/implications: The question of how to meet the spiritual needs of people with autism and severe intellectual disability is a neglected research area. Research examining the spiritual needs of service users with intellectual disabilities, on mental health inpatient units, is also needed as well as a review of whether spiritual needs are being met in current person-centred care plans. Originality/value: No published literature review was identified that specifically addressed the question of how mental health clinicians should approach the spiritual needs of their service users. (Publisher abstract)
Service evaluation of an integrated assessment and treatment service for people with intellectual disability with behavioural and mental health problems
- Authors:
- RICHINGS Ceri, COOK Rachael, ROY Ashok
- Journal article citation:
- Journal of Intellectual Disabilities, 15(1), March 2011, pp.7-19.
- Publisher:
- Sage
- Place of publication:
- London
An isolated inpatient ward for people with intellectual disabilities and additional mental health and behavioural problems was developed into a more flexible service integrating inpatient beds, day assessment, outreach and the local community learning disability teams. In this study, The Birmingham Community Assessment and Treatment Service (BCATS) was evaluated on the basis of the way it was utilised in its first 2 years, and its outcomes, and compared with the pre-existing, more traditional inpatient ward. Findings revealed that, although the new service model treated a higher number of people, it was more able to prevent or shorten inpatient admissions and to prevent placement breakdown and reduce aggressive incidents amongst inpatients during their stay. The study concluded that the model studied had been a more effective, more flexible and safer service than the previous more traditional model.
Addressing alcohol and drug addiction among people with mental retardation in nonaddiction settings: a need for cross-system collaboration
- Authors:
- SLAYTER Elspeth, STEENROD Shelley A.
- Journal article citation:
- Journal of Social Work Practice in the Addictions, 9(1), January 2009, pp.71-90.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
The evidence suggests that substance abuse services for people with learning disabilities are likely to be received in nonaddiction settings that are generally focused on mental health services and are unequipped to service and support such clients. This article aims to provide social workers in nonaddiction settings with the tools to conduct substance abuse screening and to engage with colleagues in addiction settings to bring about effective intervention. The article discusses the risk, consequences and prevalence of substance abuse in people with learning disabilities, and the issues regarding their access to treatment. Current knowledge about substance abuse screening, assessment, and intervention in people with mental retardation is covered. Finally, the article concludes with a basic framework for social workers in mental health services to improve cross-system collaboration with social workers in substance abuse when working with a client with learning disabilities and substance abuse.
CAMDEX-DS: the Cambridge examination for mental disorders of older people with Down's syndrome and others with intellectual disabilities
- Authors:
- BALL Sara, et al
- Publisher:
- Cambridge University Press
- Publication year:
- 2006
- Pagination:
- 114p.
- Place of publication:
- Cambridge
This volume is a comprehensive assessment tool for diagnosing dementia in people with Down's syndrome (a group known to be at particular risk of dementia). Based upon CAMDEX-R, CAMDEX-DS has been modified for use with intellectual disability. In order to differentiate decline due to dementia or other mental disorders from pre-existing impairment, particular emphasis has been placed on establishing change from the individual's best level of functioning. A framework for structured informant interview, a direct assessment of the patient/participant (CAMCOG), and guidance for diagnosis and intervention are included, providing a reliable way to identify dementia. Aimed at mental health professionals in community based settings, it can also aid on-going evaluation and inform future support and intervention strategies.
Psychosocial interventions for adults with intellectual disabilities and mental health problems: A review
- Author:
- HATTON Chris
- Journal article citation:
- Journal of Mental Health, 11(4), August 2002, pp.357-373.
- Publisher:
- Taylor and Francis
- Place of publication:
- London
This article briefly reviews existing evidence concerning psychosocial interventions for adults with intellectual disabilities and mental health problems. Research evidence concerning the epidemiology of mental health problems in adults with intellectual disabilities is discussed, focusing on issues in the reliable and valid identification of mental health problems in this user group and the results of prevalence studies. Current evidence concerning the use and effectiveness of psychosocial interventions for people with intellectual disabilities and mental health problems is then outlined. Particular attention is paid to cognitive-behavioural interventions. Finally, issues concerned with adapting psychosocial interventions for people with intellectual disabilities and mental health problems are discussed.
Assessment of mental health problems
- Author:
- MOSS Steve
- Journal article citation:
- Tizard Learning Disability Review, 4(2), April 1999, pp.14-19.
- Publisher:
- Emerald
Examines the process of assessing mental health needs for people with learning disabilities, considering questions of targeting, mental illness and challenging behaviour, diagnostic assessment and quality of life. Recommends comprehensive assessment within an integrated care approach.