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Challenges and responses: report of a seminar 16-17 march 1992, Park Hotel, Cardiff
- Author:
- GREAT BRITAIN. Welsh Office. All Wales Advisory Panel on the Development of Services for People with Mental Handicaps
- Publisher:
- Great Britain. Welsh Office
- Publication year:
- 1992
- Pagination:
- 56p.
- Place of publication:
- Cardiff
Report from a seminar on provision of services to people with learning difficulties, who also have challenging behaviour, mental illness or who offend.
Service responses to people with learning difficulties and challenging behaviour
- Editor:
- HARRIS John
- Publisher:
- British Institute of Mental Handicap
- Publication year:
- 1991
- Pagination:
- 78p.,bibliogs.
- Place of publication:
- Kidderminster
Papers from 3 seminars focusing on service provision for adults with a mental handicap who are mentally ill, who have behaviour problems, or who offend. Examples of service innovation are included.
Challenging behaviour and offending behaviours
- Authors:
- BOER Harm, IYER Anupama
- Journal article citation:
- Tizard Learning Disability Review, 25(3), 2020, pp.117-124.
- Publisher:
- Emerald
Purpose: The purpose of this paper is to explore three main areas in relation to the interface between challenging behaviour and offending. Design/methodology/approach: The first aim is to explore the labelling of behaviours as challenging or offending behaviour in the light of legal definitions, staff knowledge and beliefs and the mental capacity and mental health acts. The second is to explore challenging behaviour as a risk factor for offending in people with Intellectual Disability (ID). The third aim is to discuss the challenging behaviour as a barrier to discharge from secure services. Findings: There is limited research suggesting that challenging behaviour such as physical aggression can lead to longer stay in forensic services, and this warrants further research. Originality/value: This paper aims to promote discussion about the interface of offending and challenging behaviour in people with IDs and to promote best practice. (Edited publisher abstract)
Perpetrators of domestic violence abuse within Intellectual Disability services: a hidden population?
- Authors:
- SWIFT Charlotte, WAITES Erin, GOODMAN Wendy
- Journal article citation:
- British Journal of Learning Disabilities, 46(2), 2018, pp.74-81.
- Publisher:
- Wiley
Background: Domestic violence abuse (DVA) has been identified by the UK Government as a priority to address. Whilst there is a growing body of research into perpetrators of DVA from the mainstream population, there is scant research into perpetrators of DVA who have an intellectual disability. This lack of an evidence base suggests there may be a group of individuals for whom there is no suitable treatment approach. A Forensic Community Learning Disabilities Team (FCLDT) completed a multiservice evaluation of their service and sector CLDTs to obtain a measure of local unmet need. Materials and methods: A retrospective review was completed for referrals to the FCLDT and four of their sector CLDTs for 2014 and 2015. A record sheet was designed for the process of data collection and the analysis of referrals. Results: In regard to the FCLDT, 14% of the total referrals made to the FCLDT in 2014 referenced DVA perpetration and the figure rose to 26% in 2015. For CLDTs, 1.9% of the total referrals made to the CLDT in 2014 and 3.18% in 2015 referenced DVA perpetration. Conclusions: A significant proportion of referrals to the Forensic CLDT relate to the perpetration of domestic violence abuse. A proportion of Sector CLDT referrals made reference to behaviours that, according to the Home Office definition, would be classified as domestic violence abuse, but was infrequently referred to as such. The paper considers these findings in the light of the Home Office definition and its application to people with intellectual disabilities. (Edited publisher abstract)
Quality outcomes at Chestnut Drive
- Authors:
- THOMAS Derek, RUCKER Lyn, RIMMER Melanie
- Publisher:
- National Development Team
- Publication year:
- 1997
- Pagination:
- 47p.
- Place of publication:
- Manchester
Looks at service provision in a residential unit for people with learning difficulties who have committed offences and for people with severe challenging behaviour. Examines: policy issues; service design; quality safeguards already in place; outcomes; safeguards; and implications and recommendations arising from the report.
A regional mental impairment service
- Authors:
- CUMELLA Stuart, SANSOM David
- Journal article citation:
- Mental Handicap Research, 7(3), 1994, pp.257-272.
- Publisher:
- BIMH Publications
There is no consistent pattern of services in England for people with learning disability who offend or have severe anti-social behaviours. Looks at services in one English health region where the mental impairment service comprises two residential units on hospital sites. Recommends that priority be given to the development of local mental impairment services rather than new medium-secure assessment units.
Trauma and institutional risk in a secure developmental disorder service: does the SAVRY inflate risk in adolescents exposed to ACEs?
- Authors:
- WEBB Elanor Lucy, et al
- Journal article citation:
- Journal of Intellectual Disabilities and Offending Behaviour, 13(1), 2022, pp.32-44.
- Publisher:
- Emerald
Purpose: Adverse childhood experiences (ACEs) are highly prevalent in people with developmental disorders who engage in offending behaviour. Many violence-based risk assessment tools include items pertaining to ACEs, and may inflate risk scores in trauma-exposed groups. This paper aims to explore the relationships between ACEs, risk assessment scores, incidents of risk and restrictive practices, in adolescents with developmental disorders in a forensic inpatient setting. Design/methodology/approach: Secondary analysis was conducted on clinical data for 34 adolescents detained to a developmental disorder service. Data were extracted for Structured Assessment of Violence Risk in Youth (SAVRY) risk scores and risk behaviours and restrictive practices, as measures of observed risk. Findings: Participants exposed to more ACEs had higher SAVRY risk scores (p < 0.001, two-tailed), with elevations specifically on the historical subscale (p < 0.001, two-tailed). Neither ACEs nor risk scores were associated with the frequency of risk behaviours. Nevertheless, participants exposed to four or more ACEs were secluded more frequently (p = 0.015, two-tailed), indicating a potential association between trauma and risk severity. Those with more complex developmental disorders experienced fewer ACEs (p = 0.02, two-tailed) and engaged in self-harm behaviours less frequently (p = 0.04, two-tailed). Research limitations/implications: The inclusion of ACEs in risk assessment tools may lead to the inadvertent stigmatization of trauma-exposed individuals. Further investigation is necessary to offer clarity on the impact of early adversity on risk assessment accuracy and levels of institutional risk, and the role of developmental disorders in this relationship. Originality/value: To the best of the authors’ knowledge, this study is the first to explore the relative associations between ACEs, risk assessment scores and observed institutional risk and does so in a highly marginalized population. (Edited publisher abstract)
Adults with autism spectrum disorder and learning disability presenting with challenging behaviour: how tolerant should we be?
- Authors:
- RAGGI Cristian, et al
- Journal article citation:
- Journal of Intellectual Disabilities and Offending Behaviour, 4(1/2), 2013, pp.42-52.
- Publisher:
- Emerald
Purpose: Reporting to the police incidents of challenging behaviour displayed by inpatients with autism spectrum disorders (ASD) and learning disability (LD) represents an important but often controversial issue. The purpose of this paper is to contribute to this topic through a brief literature review and the presentation of a clinical case. Design/methodology/approach: Case study and literature review. Findings: The action of reporting to the police can be a useful tool within the therapeutic input provided to patients with ASD and LD who present with challenging behaviour. This can enable staff to feel legally supported, and can promote patients’ learning of social rules, in respect of their rights and duties. The clinical case highlighted that reporting to the police can be effective when it is part of a comprehensive, multi-professional therapeutic process. This should aim at directing patients towards rehabilitation rather than incarceration. This should also entail the identification of clear pathways and ongoing involvement of patients and families. Originality/value – Despite the relevance for clinical practice of the above debate, little has been published on this topic. This paper contributes to this discussion through the presentation of a clinical case and by describing how this issue was addressed within a secure inpatient setting. (Publisher abstract)
People with learning disabilities in a low secure in-patient unit: comparison of offenders and non-offenders
- Authors:
- REED Suzie, et al
- Journal article citation:
- British Journal of Psychiatry, 185(12), December 2004, pp.499-504.
- Publisher:
- Cambridge University Press
People with learning disability who exhibit challenging behaviour are frequently segregated from services and local teams are often reluctant to receive them back into their care. This situation is worse in those whose challenging behaviour includes a forensic history, but the difference between those labelled as challenging and those treated as offenders is not clear, and there is a lack of evidence about treatment effectiveness. The aim was to test between-group differences in aggression and treatment outcome in people with learning disability and challenging behaviour, with and without a forensic history. Clinical records of 86 former in-patients (45 offenders and 41 non-offenders) of a specialist unit were compared on measures of behavioural disturbance and placement outcome. People in the offenders group were significantly less likely to be aggressive to others and to use weapons, but significantly more likely to harm themselves compared with the non-offenders group. Both groups had a significant reduction in their challenging behaviour during admission, and there was no significant difference in treatment outcome. The negative reputation of people with learning disabilities who offend needs to be reconsidered.
Transitions: placing a son or daughter with intellectual disability and challenging behaviour in alternative residential provision
- Author:
- ALBORZ Alison
- Journal article citation:
- Journal of Applied Research in Intellectual Disabilities, 16(1), March 2003, pp.75-88.
- Publisher:
- Wiley
The timing of moves to alternative care has implications for the effective support of people with intellectual disabilities and their families. Three transition profiles have been proposed: ‘normative’, ‘stress process’ and ‘postponed’. The applicability of these profiles to people with intellectual disabilities and challenging behaviour was tested. It was found that few people moved due to ‘normative’ family life cycle changes. The majority left because of family difficulties (‘stress process’). This model was elaborated and three transition routes described: ‘forensic’– involving police contact (actual/potential), ‘family’, reflecting problems in the family and ‘service, deficits leading to placement out of district. This research suggests that people (particularly young men) with intellectual disabilities and challenging behaviour enter statutory care earlier than their counterparts, and people with different levels of intellectual and physical disabilities follow different transition routes.