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Outcomes of an inner city forensic intellectual disability service
- Authors:
- WOOSTER Leah, McCARTHY Jane, CHAPLIN Eddie
- Journal article citation:
- Journal of Intellectual Disabilities and Offending Behaviour, 9(1), 2018, pp.1-8.
- Publisher:
- Emerald
Purpose: National policy in England is now directed towards keeping patients with intellectual disability (ID) presenting with forensic problems for time-limited treatment. The result is that secure hospital services are expected to work much more proactively to discharge patients to community-based services. However, there is little evidence in recent years on the outcome of discharged patients with ID from secure hospitals. The purpose of this paper is to describe the outcomes of a patient group discharged from a specialist forensic ID service in London, England. Design/methodology/approach: This is a descriptive retrospective case note study of patients with ID admitted to and discharged from a secure service with both low and medium secure wards, over a six-year period from 2009 to 2016. The study examined patient demographic, clinical and outcome variables, including length of stay, pharmacological treatment on admission and discharge, offending history and readmissions to hospital and reoffending following discharge. Findings: The study identified 40 male patients, 29 of which were admitted to the medium secure ward. In all, 27 patients (67.5 per cent) were discharged into the community with 14 patients having sole support from the community ID services and 4 from the community forensic services. In total, 20 per cent of patients were readmitted within the study period and 22.2 per cent of patients received further convictions via the Criminal Justice System following discharge. Originality/value: This was a complex group of patients with ID discharged into the community with a number at risk of requiring readmission and of reoffending. Community-based services providing for offenders with ID must have sufficient expertise and resourcing to manage the needs of such a patient group including the ongoing management of risks. The national drive is significantly to reduce the availability of specialist inpatient services for this group of patients but this must occur alongside an increase in both resources and expertise within community services. (Edited publisher abstract)
Does substance use predict contact with the criminal justice system for people with intellectual disabilities?
- Authors:
- CHAPLIN Eddie, et al
- Journal article citation:
- Journal of Intellectual Disabilities and Offending Behaviour, 5(3), 2014, pp.147-153.
- Publisher:
- Emerald
Purpose: The purpose of this paper is to examine how substances misuse impacts on exposure to the criminal justice system for people with intellectual disabilities (ID). Design/methodology/approach: An electronic case-register of mental health patients was used to examine the clinical records of 411 patients with ID. χ2 analysis was performed to test the association between variables and logistic regression to generate estimates for statistically significant association variables. Findings: Of 411 cases, 98 (23 per cent) of patient had a history of substance use, with affective disorders strongly associated with alcohol misuse χ2=4.135, df=1 (p<0.042), similarly statistically significant predictor for alcohol misuse OR: 1.7, 95 per cent CI (1.02-2.72) (p<0.043). Patients with a history of offending behaviour had three-folds higher risk to misuse drugs compared to those without a forensic conviction OR: 3.17, 95 per cent CI (1.35-7.44) (p<0.008). Those with a history of offending were more likely to have had a history of substance use. Originality/value: Substance use and its impact on offending by people with ID is still poorly understood. This paper adds new information to this under researched area. (Publisher abstract)