Journal of Learning Disabilities and Offending Behaviour, 3(1), 2012, pp.24-35.
Publisher:
Emerald
This article examines how a patient centred recovery approach was implemented in a secure learning disabilities service. The Recovery Star; a measure of individual recovery, was adopted for use among the patients. Staff underwent training on the use of the Recovery Star tool after which a multidisciplinary steering group made some modifications to the tool. It was found that implementing a recovery approach with the Recovery Star tool was a beneficial process for the service. Key workers working with patients thought that the structure of the Recovery Star tool opened up avenues for discussing topics that may otherwise have not been discussed as fully. The authors concluded that the Recovery Star tool, embedded in a care programme approach process, equips patients and staff for measuring the recovery journey.
This article examines how a patient centred recovery approach was implemented in a secure learning disabilities service. The Recovery Star; a measure of individual recovery, was adopted for use among the patients. Staff underwent training on the use of the Recovery Star tool after which a multidisciplinary steering group made some modifications to the tool. It was found that implementing a recovery approach with the Recovery Star tool was a beneficial process for the service. Key workers working with patients thought that the structure of the Recovery Star tool opened up avenues for discussing topics that may otherwise have not been discussed as fully. The authors concluded that the Recovery Star tool, embedded in a care programme approach process, equips patients and staff for measuring the recovery journey.
Subject terms:
learning disabilities, mental health services, person-centred care, recovery approach;
British Journal of Social Work, 35(7), October 2005, pp.1039-1062.
Publisher:
Oxford University Press
This paper reports on the organization of care management from a longitudinal study of community care for people resettled from long-stay learning disability and psychiatric hospitals. The findings from a 12-year follow-up of care management arrangements in 12 learning disability and eight mental health study site services are described. The diversity of care management arrangements found at earlier points in the evaluation remained evident. Also, many of the former ‘care in the community’ service users were excluded from mainstream care management arrangements in their localities. The difficulty of developing person-centred arrangements in learning disability and the lack of integration of the Care Programme Approach and care management were evident. The findings and observations are placed in the wider policy and practice context, with suggestions for taking care management forward nationally and locally.
This paper reports on the organization of care management from a longitudinal study of community care for people resettled from long-stay learning disability and psychiatric hospitals. The findings from a 12-year follow-up of care management arrangements in 12 learning disability and eight mental health study site services are described. The diversity of care management arrangements found at earlier points in the evaluation remained evident. Also, many of the former ‘care in the community’ service users were excluded from mainstream care management arrangements in their localities. The difficulty of developing person-centred arrangements in learning disability and the lack of integration of the Care Programme Approach and care management were evident. The findings and observations are placed in the wider policy and practice context, with suggestions for taking care management forward nationally and locally.
Subject terms:
learning disabilities, mental health services, care management, community care;
University of Leicester. Nuffield Community Care Studies Unit
Publication year:
1995
Pagination:
57p
Place of publication:
Leicester
The Health of the Nation document (1992) identified services for mentally disordered offenders (MDOs) as a priority problem. It is against this background that Leicestershire Health has asked for a literature review of services for this client category in order to inform the commissioning process. This review is chiefly concerned with the overall pattern of services which should be available for MDOs and does not include material specific to the technical skills of the various professionals who provide help for MDOs. For example, there is no discussion of the sorts of therapies which can be used for different sorts of offenders. It is assumed that such information will form part of individual professionals' own skills. Information is not given on specific client categories, such as women, ethnic minorities and people with learning disabilities, or on consumer views.
The Health of the Nation document (1992) identified services for mentally disordered offenders (MDOs) as a priority problem. It is against this background that Leicestershire Health has asked for a literature review of services for this client category in order to inform the commissioning process. This review is chiefly concerned with the overall pattern of services which should be available for MDOs and does not include material specific to the technical skills of the various professionals who provide help for MDOs. For example, there is no discussion of the sorts of therapies which can be used for different sorts of offenders. It is assumed that such information will form part of individual professionals' own skills. Information is not given on specific client categories, such as women, ethnic minorities and people with learning disabilities, or on consumer views.
Extended abstract:
Author:DREWETT Alison Title: A literature review of services for mentally disordered offenders Publisher: University of Leicester. Nuffield Community Care Studies Unit, 1995
Summary
This review is chiefly concerned with the overall pattern of services which should be available for mentally disordered offenders (MDOs), and does not include material specific to the technical skills of the various professionals who provide help for MDOs. For example, there is no discussion of the sorts of therapies which can be used for different sorts of offenders. It is assumed that such information will form part of individual professionals' own skills. Information is not given on specific client categories, such as women, ethnic minorities and people with learning disabilities, or on consumer views.
Context
The Health of the Nation document (1992) identified services for mentally disordered offenders (MDOs) as a priority problem. It is against this background that Leicestershire Health asked for a literature review of services for this client category in order to inform the commissioning process.
Contents
The introduction gives the background and explains how the review was carried out, concentrating chiefly on collecting unpublished and less readily available information (‘grey literature') from the varied agencies which purchase and provide services for this client category. Section 2 discusses numbers of mentally disordered offenders and the psychiatric needs of prisoners, those in contact with the probation service, those taken to police stations, and all offenders. Section 3 is about multi-agency working, discussing the problems and concluding that many agencies are now engaging in a multi-disciplinary approach and authorities are beginning to try to identify what works. The following chapters examine some of the services being put in place. Section 4 is on diverting MDOs, asking why this is done, describing where diversion takes place and the numbers identified and diversion schemes, and discussing effectiveness. Secure accommodation for mentally disordered offenders is discussed in Section 5: prisons, special hospitals, regional secure units, and psychiatric wards, ending with service developments in providing a coherent secure service and assessing risk. Section 6 covers community care for MDOs, with sections on training and service problems. The publication concludes that although the principle of providing health care instead of punishment for MDOs is not new, coherent health and social care is not available for all in the UK , and the level depends very much on where they live. Agencies must work together. The comparatively few offenders presenting serious danger tend to distort responses, with the risk of resources being concentrated on them at the expense of the far more numerous others. Some psychopaths may not receive any health care because they are considered untreatable. All parts are interdependent and repercussions of neglect will be felt elsewhere. While, in theory, there is a push towards helping all types of clients have access to generic services, there is nevertheless some call for specific services staffed by for generic professionals.those trained to help MDOs – as if, in practice, generic services were not answering. Given the scale of need, services are unlikely to be able to given all the help all MDOs need, so there must be a balance between providing highly specialised services on the one hand and, on the other, educating staff in generic services so that they are able to respond to the needs of MDOs. Specialist staff should be available in an advisory capacity
64 references
Subject terms:
learning disabilities, literature reviews, mental health services, mentally disordered offenders;
Journal of Applied Research in Intellectual Disabilities, 35(1), 2022, pp.252-260.
Publisher:
Wiley
Background: A recovery approach within mental health services has gained momentum. Its meaning for adults with intellectual disabilities recovering from mental health disorders is less understood. Peoples' experiences of recovery were explored to help inform recovery-focused recommendations for clinical practise. Method: A qualitative design using interpretative phenomenological analysis was applied. Nine interviews with people with intellectual disabilities who had experienced mental health disorders were conducted. Results: Two themes that emerged focusing on entry to service and the recovery experience. Subthemes for entry to service included unfair treatment, valuing information and managing expectations. The recovery experience subthemes were therapeutic alliance, self-management, emotional development, autonomy, connectedness, positive identity and a belief in recovery. Conclusions: Hearing peoples' experiences directly allowed the current themes to emerge in the context of living with lifelong disabilities. This article adds to the sparse literature and highlights considerations for recovery-based interventions for people with intellectual disabilities.
(Edited publisher abstract)
Background: A recovery approach within mental health services has gained momentum. Its meaning for adults with intellectual disabilities recovering from mental health disorders is less understood. Peoples' experiences of recovery were explored to help inform recovery-focused recommendations for clinical practise. Method: A qualitative design using interpretative phenomenological analysis was applied. Nine interviews with people with intellectual disabilities who had experienced mental health disorders were conducted. Results: Two themes that emerged focusing on entry to service and the recovery experience. Subthemes for entry to service included unfair treatment, valuing information and managing expectations. The recovery experience subthemes were therapeutic alliance, self-management, emotional development, autonomy, connectedness, positive identity and a belief in recovery. Conclusions: Hearing peoples' experiences directly allowed the current themes to emerge in the context of living with lifelong disabilities. This article adds to the sparse literature and highlights considerations for recovery-based interventions for people with intellectual disabilities.
(Edited publisher abstract)
Subject terms:
learning disabilities, recovery, user views, mental health problems, mental health services;
Journal of Intellectual Disabilities, 25(3), 2021, pp.357-369.
Publisher:
Sage
Place of publication:
London
This study evaluates the implementation of Safewards on an assessment and treatment unit (ATU) for people with an intellectual disability. There are no previous studies evaluating this model in this context and previous research has focused largely on acute mental health services. The ‘Patient–Staff Conflict Shift Report’ was used at baseline for 1 month and 1 year later, after all the interventions had been implemented, to evaluate the impact of Safewards. Significant reductions were found in conflict and containment measures used within the service after the implementation of Safewards. Staff who led on the interventions were also asked to give feedback on their experiences, the challenges they faced and how they would like to move forward. Safewards was generally seen as a positive approach by the team. Limitations of this study are highlighted and suggestions for future research are made.
(Edited publisher abstract)
This study evaluates the implementation of Safewards on an assessment and treatment unit (ATU) for people with an intellectual disability. There are no previous studies evaluating this model in this context and previous research has focused largely on acute mental health services. The ‘Patient–Staff Conflict Shift Report’ was used at baseline for 1 month and 1 year later, after all the interventions had been implemented, to evaluate the impact of Safewards. Significant reductions were found in conflict and containment measures used within the service after the implementation of Safewards. Staff who led on the interventions were also asked to give feedback on their experiences, the challenges they faced and how they would like to move forward. Safewards was generally seen as a positive approach by the team. Limitations of this study are highlighted and suggestions for future research are made.
(Edited publisher abstract)
Subject terms:
evaluation, intervention, learning disabilities, therapy and treatment, mental health services;
Advances in Mental Health and Intellectual Disabilities, 12(3-4), 2018, pp.91-98.
Publisher:
Emerald
Purpose: Services for people with intellectual disabilities in the UK have evolved over the years from hospital-based care to more community provision. There are multiple reasons for these changes, however, often it was due to changes in social policy or following a scandal in provision. The paper aims to discuss these issues. Design/methodology/approach: Providing services to meet the health and social care needs of people with intellectual disabilities is well-established in the four countries of the UK with support from legislation. There are often specialist mental health and social care teams. Dedicated professionals work with people with intellectual disabilities who experience mental health problems with a focus on support in the community. A range of services for children and adults and for offenders exist across the UK that often vary in composition and structure. Findings: The challenges in providing mental health services for children and adults with intellectual disabilities in the future include recruitment and training of the workforce with the remit of enhancing community support and reduced in-patient care. Practical implications: This paper helps the reader to understand how ID mental health services are organised in the UK. Originality/value: This paper gives a summary of the ID mental health services in the UK. Even though there are various papers looking at different aspects of mental health services for people with ID in the UK, this paper brings all that information together to help reader get a better understanding of the mental health services for people with ID.
(Publisher abstract)
Purpose: Services for people with intellectual disabilities in the UK have evolved over the years from hospital-based care to more community provision. There are multiple reasons for these changes, however, often it was due to changes in social policy or following a scandal in provision. The paper aims to discuss these issues. Design/methodology/approach: Providing services to meet the health and social care needs of people with intellectual disabilities is well-established in the four countries of the UK with support from legislation. There are often specialist mental health and social care teams. Dedicated professionals work with people with intellectual disabilities who experience mental health problems with a focus on support in the community. A range of services for children and adults and for offenders exist across the UK that often vary in composition and structure. Findings: The challenges in providing mental health services for children and adults with intellectual disabilities in the future include recruitment and training of the workforce with the remit of enhancing community support and reduced in-patient care. Practical implications: This paper helps the reader to understand how ID mental health services are organised in the UK. Originality/value: This paper gives a summary of the ID mental health services in the UK. Even though there are various papers looking at different aspects of mental health services for people with ID in the UK, this paper brings all that information together to help reader get a better understanding of the mental health services for people with ID.
(Publisher abstract)
Subject terms:
learning disabilities, mental health services, mental health problems, training, community care;
Advances in Mental Health and Intellectual Disabilities, 6(4), 2012, pp.192-198.
Publisher:
Emerald
This paper explores the similarities between recovery principles and existing approaches in services for people with intellectual disabilities, and reflects on the potential barriers to the explicit uptake of the “recovery” approach in this context. The authors examine existing practices that could be described as recovery oriented, along with reflections on how these relate to the recovery approach. Questions are raised regarding whether practices can be regarded as “recovery oriented”, without first consulting service users. Given the increasing emphasis on recovery approaches within mainstream services, it seems vital to give consideration to the potential for its meaningful application to people with intellectual disabilities and mental health problems.
This paper explores the similarities between recovery principles and existing approaches in services for people with intellectual disabilities, and reflects on the potential barriers to the explicit uptake of the “recovery” approach in this context. The authors examine existing practices that could be described as recovery oriented, along with reflections on how these relate to the recovery approach. Questions are raised regarding whether practices can be regarded as “recovery oriented”, without first consulting service users. Given the increasing emphasis on recovery approaches within mainstream services, it seems vital to give consideration to the potential for its meaningful application to people with intellectual disabilities and mental health problems.
Subject terms:
learning disabilities, mental health services, person-centred planning, recovery approach, evaluation;
Advances in Mental Health and Intellectual Disabilities, 4(4), December 2010, pp.9-14.
Publisher:
Emerald
This article provides a reflection on the current status of mental health services for people with intellectual disabilities against the historical and philosophical trend towards ‘mainstreamed’ services for this group of people. Present day services for people with intellectual disabilities would be barely recognisable to clinicians working half a century ago. Firstly, there was the closure of the institution-like hospitals as part of a general reorientation within psychiatry from the asylum to the community. Secondly, there has been a push towards incorporating people with intellectual disabilities in ‘mainstream’ services. This principle of ‘normalisation’ sits at the heart of health and social policy in the UK for people with learning disabilities. Despite this, psychiatry has retained learning disability as a distinct area of specialism. This article asks whether separate mental health of intellectual disability (MHID) services offer something that really cannot be met by mainstream services, providing arguments for their continued existence as a separate specialist entity within the field of psychiatry.
This article provides a reflection on the current status of mental health services for people with intellectual disabilities against the historical and philosophical trend towards ‘mainstreamed’ services for this group of people. Present day services for people with intellectual disabilities would be barely recognisable to clinicians working half a century ago. Firstly, there was the closure of the institution-like hospitals as part of a general reorientation within psychiatry from the asylum to the community. Secondly, there has been a push towards incorporating people with intellectual disabilities in ‘mainstream’ services. This principle of ‘normalisation’ sits at the heart of health and social policy in the UK for people with learning disabilities. Despite this, psychiatry has retained learning disability as a distinct area of specialism. This article asks whether separate mental health of intellectual disability (MHID) services offer something that really cannot be met by mainstream services, providing arguments for their continued existence as a separate specialist entity within the field of psychiatry.
Subject terms:
learning disabilities, mental health services, policy, psychiatry, social role valorisation;
Journal of Intellectual Disability Research, 54(Supplement 1), April 2010, pp.16-27.
Publisher:
Wiley
At the turn of the 1970s the National Association for Mental Health, a voluntary organisation working closely with psychiatrists and the government to provide residential services and educational courses, adopted the 'brand name' MIND as part of its transformation into a campaigning pressure group. This article explores the historical background to key statements made by the organisation at this time regarding the association of mental health with, what was previously known as, mental handicap. The National Association for Mental Health is placed within the historical context of the movement for mental hygiene. The article investigates how the movement theorised mental health as critically related to intellect and emotionality. The author describes how the movement relegated people deemed ‘mentally deficient’ from therapeutic policies based on family relationships believed to promote mental health, and goes on to discuss the way in which a late 1950s experiment known as the Brooklands study undermined this discrimination. This was, the author suggests, paradoxical, since it built on mental hygiene theorising. The article concludes that theorisations of the relationship between intellect, emotion and mental health are still potentially discriminatory.
At the turn of the 1970s the National Association for Mental Health, a voluntary organisation working closely with psychiatrists and the government to provide residential services and educational courses, adopted the 'brand name' MIND as part of its transformation into a campaigning pressure group. This article explores the historical background to key statements made by the organisation at this time regarding the association of mental health with, what was previously known as, mental handicap. The National Association for Mental Health is placed within the historical context of the movement for mental hygiene. The article investigates how the movement theorised mental health as critically related to intellect and emotionality. The author describes how the movement relegated people deemed ‘mentally deficient’ from therapeutic policies based on family relationships believed to promote mental health, and goes on to discuss the way in which a late 1950s experiment known as the Brooklands study undermined this discrimination. This was, the author suggests, paradoxical, since it built on mental hygiene theorising. The article concludes that theorisations of the relationship between intellect, emotion and mental health are still potentially discriminatory.
Subject terms:
learning disabilities, mental health care, mental health problems, mental health services, social work history;
Journal of Applied Research in Intellectual Disabilities, 20(5), September 2007, pp.430-438.
Publisher:
Wiley
This study examined the distribution of service resources using a mental health service for people with learning disabilities. A service consumption index based on the number of outpatient clinics attended, contacts with the community psychiatric nurses, home visits by a psychiatrist and the number of admissions was constructed. This consumption index was used to divide the sample (n = 115) into two groups: heavy and light service users. Logistic regression analysis indicated that, after controlling for the length of service contact, individuals with a diagnosis of schizophrenia spectrum disorder and those with a greater number of affective/neurotic symptoms were more likely to be heavy service users. Age, living situation and the degree of intellectual disabilities were not found to be significant predictors of service consumption. The results also suggest that a small proportion of service users consumed almost half of the service resources.
This study examined the distribution of service resources using a mental health service for people with learning disabilities. A service consumption index based on the number of outpatient clinics attended, contacts with the community psychiatric nurses, home visits by a psychiatrist and the number of admissions was constructed. This consumption index was used to divide the sample (n = 115) into two groups: heavy and light service users. Logistic regression analysis indicated that, after controlling for the length of service contact, individuals with a diagnosis of schizophrenia spectrum disorder and those with a greater number of affective/neurotic symptoms were more likely to be heavy service users. Age, living situation and the degree of intellectual disabilities were not found to be significant predictors of service consumption. The results also suggest that a small proportion of service users consumed almost half of the service resources.
Subject terms:
learning disabilities, mental health problems, mental health services, referral, service uptake;