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Variation in rates of inpatient admissions and lengths of stay experienced by adults with learning disabilities in England
- Authors:
- JAMES Elaine, HATTON Chris, BROWN Mark
- Journal article citation:
- Tizard Learning Disability Review, 22(4), 2017, pp.211-217.
- Publisher:
- Emerald
Purpose: The purpose of this paper is to analyse rates of inpatient admissions for people with learning disabilities in England and to identify factors associated with higher rates of inpatient admission. Design/methodology/approach: Secondary analysis of data submitted as part of the Transforming Care programme in England. Findings: 2,510 people with learning disabilities in England were inpatients on 31st March 2016. Findings indicate that people with learning disabilities are at risk of higher rate of inpatient admission than can be explained by prevalence within the general population; this risk may be associated with areas where there are higher numbers of inpatient settings which provide assessment and treatment for people with learning disabilities. Research limitations/implications: Variability in the quality of the data submitted by commissioners across the 48 Transforming Care Plan areas mean that greater attention needs to be paid to determining the validity of the common reporting method. This would improve the quality of data and insight from any future analysis. Practical implications: The study’s findings are consistent with the hypothesis that geographical variations in the risk of people with learning disabilities being admitted to inpatient services are not consistent with variations in prevalence rates for learning disability. The findings support the hypothesis that building alternatives to inpatient units should impact positively on the numbers of learning disabled people who are able to live independent lives. Originality/value: This is the first study which examines the data which commissioners in England have reported to NHS England on the experience of people with learning disabilities who are admitted as inpatients and to report on the possible factors which result in higher rates of inpatient admission. (Publisher abstract)
Application of community treatment orders (CTOs) in adults with intellectual disability and mental disorders
- Authors:
- GUPTA Jaya, et al
- Journal article citation:
- Advances in Mental Health and Intellectual Disabilities, 9(4), 2015, pp.196-205.
- Publisher:
- Emerald
Purpose: The purpose of this paper is to explore use of community treatment orders (CTOs) in adults with intellectual disability (ID) and mental health problems across England and Wales. Design/methodology/approach: A web-based exploratory survey was sent to 359 consultants on the database of the Faculty of the Psychiatry of ID, Royal College of Psychiatrists who had declared ID as their main speciality. Socio-demographic details of responding consultants, clinical characteristics of adults with ID on CTO, subjective views of consultants on using CTOs in people with ID were collected and analysed. Findings: In total, 94 consultant questionnaires were returned providing information on 115 patients detained under CTO. More than 75 per cent of the respondents had used CTO in their clinical practice. Patients subject to CTO were generally young, white males with mild ID and living in supported accommodation. CTOs were primarily used in situations of non-engagement (52.2 per cent), non-compliance with medication (47 per cent) or non-compliance with social care supports (49.6 per cent). Practical implications: Responding consultants expressed concerns about encroachment of civil liberties and ethics of using CTOs in people with ID who may lack capacity and stressed that decision to use CTOs needs to be therefore done on individual basis. Originality/value: This is the first national study to examine the practice of applying CTOs in adults with ID and mental disorders. Current practice is based on evidence from research done in adults with normal intelligence. Further research is needed to investigate the utility of CTOs in routine clinical practice in adults with ID and mental disorders. (Publisher abstract)
It's good to talk
- Author:
- McMILLAN Ian
- Journal article citation:
- Learning Disability Today, 15(2), March/April 2015, pp.12-13.
- Publisher:
- Pavilion
- Place of publication:
- Hove
To help to make talking therapies more accessible to people with learning disabilities and mental health issues Oxleas NHS Foundation Trust launched the TLC service, a therapeutic service for Greenwich residents with learning disabilities in July 2013. From launch to the end of 2014 the service received over 50 referrals. This article explains how the service helped one 21-year-old who was unemployed and was also experiencing severe anxiety. (Edited publisher abstract)
Strategic thinking
- Authors:
- DAVIES Jill, BURKE Christine
- Journal article citation:
- Mental Health Today, September 2012, pp.12-14.
- Publisher:
- Pavilion
- Place of publication:
- Hove
People with learning disabilities are more likely to develop mental health problems compared to the general population. The Government’s mental health strategy, ‘No health without mental health’ (DH, 2011), makes several references to people with learning disabilities. In particular, it highlights the importance of mental health services for people with learning disabilities and autism, the need to ensure that mainstream services are inclusive to this group, including that staff have appropriate skills and can provide reasonable adjustments to meet individual needs. The strategy also mentions the need for early intervention to prevent later problems for children with special educational needs and disabilities, including those who have underlying or associated mental health problems. In 2012, the Government issued an accompanying implementation framework that aims to translate the ideals of the strategy into concrete actions on a local level. This article discusses what the implementation framework means for people with learning disabilities. It shows that, despite the strategy highlighting the needs of people with learning disabilities, the framework offers little specifically for this group. This raises concern that this group will remain off the radar for those in mainstream services and organisations that could support them to maintain their mental health and wellbeing.
Strategic thinking
- Authors:
- DAVIES Jill, BURKE Christine
- Journal article citation:
- Learning Disability Today, October 2012, pp.16-17.
- Publisher:
- Pavilion
- Place of publication:
- Hove
People with learning disabilities are more likely to develop mental health problems compared to the general population. The Government’s mental health strategy, ‘No health without mental health’ (DH, 2011), makes several references to people with learning disabilities. In particular, it highlights the importance of mental health services for people with learning disabilities and autism, the need to ensure that mainstream services are inclusive to this group, including that staff have appropriate skills and can provide reasonable adjustments to meet individual needs. The strategy also mentions the need for early intervention to prevent later problems for children with special educational needs and disabilities, including those who have underlying or associated mental health problems. In 2012, the Government issued an accompanying implementation framework that aims to translate the ideals of the strategy into concrete actions on a local level. This article discusses what the implementation framework means for people with learning disabilities. It shows that, despite the strategy highlighting the needs of people with learning disabilities, the framework offers little specifically for this group. This raises concern that this group will remain off the radar for those in mainstream services and organisations that could support them to maintain their mental health and wellbeing.
Prosecution of offenders with mental health problems or learning disabilities
- Authors:
- MAGILL Christine, RIVERS Vanessa
- Publisher:
- Great Britain. Crown Prosecution Service
- Publication year:
- 2010
- Place of publication:
- London
In November 2009, the Health and Criminal Justice Programme Board published its National Delivery Plan (NDP), which incorporates a full Government response to the recommendations of people with mental health problems or learning disabilities in the Criminal Justice System. It sets out a strategic framework and five cross-departmental objectives. The latter are underpinned with key deliverables for relevant Government Departments, including the Crown Prosecution Service (CPS). Key findings suggest that the CPS should continue to take forward work with the police to improve the completeness of monitoring data on the disability of offenders. CPS Areas should continue to deliver training locally, using a nationally agreed package, to their prosecutors as required. CPS Areas should consider establishing contact and fostering better links with local Primary Care Trusts, to increase awareness of criminal justice needs and to facilitate prosecutors' understanding of the nature of local services. Also, The CPS should revisit its guidance to see if there is scope more clearly to set out the circumstances when it would be appropriate to issue a Conditional Caution in cases involving mentally disordered offenders.
Getting the right result
- Author:
- -
- Journal article citation:
- Learning Disability Today, June 2011, pp.34-35.
- Publisher:
- Pavilion
- Place of publication:
- Hove
CMG and Pure Innovations is a national non-for-profit employment scheme that helps people with learning disabilities and mental health needs to get into work. This article describes how the scheme worked with and supported one of their clients, who had mild learning disabilities and mental health needs, so he was able to secure a permanent job.
Stepping out
- Author:
- PETERS Zelda
- Journal article citation:
- Mental Health Today, April 2011, pp.34-35.
- Publisher:
- Pavilion
- Place of publication:
- Hove
There is currently a shortage of 'step down' or 'step down' services that provide the link between secure hospital or prison settings and independent living. Building Futures, a subsidiary of Turning Point, has developed a programme that involves working with commissioners to build services which fill gaps in care and meet local need. This produces more cost effective, relevant services and prevents out of area placements. The key features of the model are described.
Clouded judgement
- Author:
- McMILLAN Ian A.
- Journal article citation:
- Learning Disability Today, 9(7), October 2009, pp.14-16.
- Publisher:
- Pavilion
- Place of publication:
- Hove
This article considers the debate around how far staff should go when it comes to encouraging clients to stop smoking. The government is increasingly funding national smoking awareness campaigns, and banning smoking in many public places, and while many members of the public have stopped smoking, there has been little change with those with mental health problems, with about 40% continuing to smoke, compared to the national average of 25%. As for people with learning disabilities, a recent study showed that only 1.9% smoked, and, considering many of those had lived in institutions all their lives, must have been introduced to smoking by staff, where 27% have been shown to smoke. The author suggests the social nature of smoking may perhaps explain why some people with learning disabilities smoke.
When one door closes…
- Author:
- McMILLIAN Ian A.
- Journal article citation:
- Learning Disability Today, 10(1), January 2010, pp.22-23.
- Publisher:
- Pavilion
- Place of publication:
- Hove
The article contains an interview with Shaun Gravestock, a full-time consultant psychiatrist at the newly opened Mental Health and Learning Disabilities at the Bethlem Royal Hospital in Beckenham, Kent. This unit caters specifically for people with learning disabilities who need intensive mental health care. It contains 13 beds, 9 funded by local primary care trusts and 4 available to commissioners around the UK. Gravestock argues that mainstream acute mental health units are not the best places for potentially vulnerable people with learning disabilities, as staff may find it difficult to establish rapport, the atmosphere can be volatile, and staff are under pressure to quickly move patients through the system. The Bethlem unit aims to fill this gap for a specialist service for those with learning disabilities and mental health problems.