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New legislative proposals for women with learning disabilities and mental health problems
- Authors:
- McNAMARA Eileen, HALL Ian
- Journal article citation:
- Tizard Learning Disability Review, 9(4), October 2004, pp.36-40.
- Publisher:
- Emerald
Several proposed changes to the law in England and Wales will particularly affect women with learning disabilities. The Sexual Offences Act 2003 and the draft Mental Health and Mental Incapacity Bills all highlight the tension between state paternalism and individual autonomy. Uses a fictional case scenario to consider the practical implications of the proposed legislation, and dilemmas that may arise.
The development of a new integrated mental health service for people with learning disabilities
- Authors:
- HALL Ian, et al
- Journal article citation:
- British Journal of Learning Disabilities, 34(2), June 2006, pp.82-87.
- Publisher:
- Wiley
It is now well recognized that people with learning disabilities experience the full range of psychiatric disorders. Public policy in the United Kingdom advocates that people with learning disabilities should access mainstream mental health services. The authors discuss the challenges this policy presents, and then describe the processes they went through to set up a service that properly enabled such access. They describe the service model in some detail, then reflect on overcoming barriers to implementation, and how we maintain the service model. Finally some lessons for future service development initiatives are highlighted.
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.
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.
Intellectual disability psychiatry: a practical handbook
- Editors:
- HASSIOTIS Angela, BARRON Diana Andrea, HALL Ian, (eds.)
- Publisher:
- Wiley-Blackwell
- Publication year:
- 2009
- Pagination:
- 276p.
- Place of publication:
- Chichester
This guide to the management of mental health problems in people with learning disabilities has been written by nearly 30 contributors from the United Kingdom, United States, Canada, Ireland and Australia. Sixteen chapters cover topics including effective communication, clinical assessment, assessing mental capacity, decision making, depression, anxiety, obsessive compulsive disorders (OCDs), post traumatic stress disorder (PTSD), psychoses, autistic spectrum disorders (ASDs), substance misuse, challenging behaviour, interaction of physical with mental health, older people, mentally disordered offenders, mental health crises, community care and pharmacological and psychological interventions. Two appendices entitled ‘Critique of the ICD 10 and DSM IV based classification of mental disorders in intellectual disability’ and ‘A to Z of disciplines that may contribute to the multi-and interdisciplinary work as applied to mood and anxiety disorders’ are also included. The publication is aimed at health professionals to develop their understanding of mental health issues of people with learning disabilities.
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.