Search results for ‘Subject term:"learning disabilities"’ Sort:
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Pathways into the criminal justice system for individuals with intellectual disability
- Authors:
- RAINA Poonam, et al
- Journal article citation:
- Journal of Applied Research in Intellectual Disabilities, 26(5), 2013, pp.404-409.
- Publisher:
- Wiley
Studies focusing on pathways in the criminal justice system for individuals with intellectual disability are limited in that they only study individuals once they are involved in the system and do not consider the pathways into it. This study examines predisposing factors that lead to various outcomes for individuals with intellectual disability when police are called to respond to their behavioural crises. The police response to 138 individuals with intellectual disability in crisis were examined. Following police intervention, 15 individuals were arrested, 76 were taken to the emergency department and 47 received on-scene resolution. Comparisons between the three groups were conducted. The three groups differed in terms of residence at the time of crisis, history of forensic involvement and type of crisis. Police intervention with adults with intellectual disability can happen for different reasons. Both individual and situational predictors explained this outcome. (Edited publisher abstract)
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)
Evaluation of treatment outcomes from a medium secure unit for people with intellectual disability
- Authors:
- ALEXANDER Regi T., et al
- Journal article citation:
- Advances in Mental Health and Intellectual Disabilities, 5(1), January 2011, pp.22-32.
- Publisher:
- Emerald
Short-term treatment outcomes were evaluated in 138 individuals (109 male) admitted over a six-year period to a 64-bedded medium secure inpatient service for offenders with mild intellectual disabilities. The aim was to audit successful treatment outcome, defined by a move to a lower level of therapeutic security, and to establish the length of hospital stay and the socio-demographic, clinical and forensic variables associated with it. Seventy seven discharged and 61 current in-patients, were included. The median length of stay for the discharged group was 2.8 years, with 75% staying for less than 5 years. About 90% of this group were discharged to lower levels of security and about a third went directly to community placements. None of the clinical and forensic factors examined was significantly associated with length of stay for this group. Of the 61 inpatients, 36 were considered ‘difficult to discharge long stay’ patients. However, a third of this group had moved to low secure rehabilitation settings within the service. The ‘difficult to discharge’ group had more patients with criminal sections, restriction orders, history of abuse, fire setting, personality disorders and substance misuse. However, when regression analysis was done, most of these factors were not found to be predictive of length of stay. The author concludes that clinical diagnosis or offending behaviour categories are poor predictors of length of hospital stay. There is a need to identify empirically derived patient clusters using a variety of clinical and forensic variables.
Sexual and nonsexual offenders with intellectual and learning disabilities: a comparison of characteristics, referral patterns, and outcome
- Authors:
- LINDSAY William R., et al
- Journal article citation:
- Journal of Interpersonal Violence, 19(8), August 2004, pp.875-890.
- Publisher:
- Sage
This article reports an evaluation of a community intellectual disability offender service over the period from 1990 to 2001. Men who committed sex offenses or sexually abusive incidents (n = 106) and men who committed other types of offenses and serious incidents (n = 78) are compared on personal characteristics, referral sources, forensic details, and outcome up to 7 years after referral. The cohorts are older than one would expect from the criminology literature, and, at about 33%, the incidence of mental illness is consistent with some previous studies. A greater proportion of sex offenders had criminal justice involvement and a formal disposal from court. Fire raising was not overly represented as an offense. There was a higher rate of reoffending in the nonsexual cohort, which persisted up to 7 years. Investigating only reoffenders, there was a considerable amount of harm reduction recorded up to 7 years, statistically significant up to 5 years following initial referral.
Discharges from a learning disabilities medium secure unit: what happens to them?
- Authors:
- HALSTEAD Simon, et al
- Journal article citation:
- British Journal of Forensic Practice, 3(1), April 2001, pp.11-21.
- Publisher:
- Emerald
Thirty-five patients who had received at least one year's treatment in a learning-disability medium secure unit were followed up for a maximum of five years. A good treatment outcome was more common in those with significant learning disability. At the end of follow up, 21 subjects (60 %) were living in the community with support. The early months after discharge were a peak period for relapse. A very low level of reconviction was found, affecting only one subject. Patients who were older on discharge were less likely to re-offend.
Recidivism following psychodynamic psychotherapy amongst offenders with intellectual disabilities
- Author:
- BEAIL Nigel
- Journal article citation:
- British Journal of Forensic Practice, 3(1), April 2001, pp.33-37.
- Publisher:
- Emerald
Reports on a study of recidivism rates following psychotherapy amongst male offenders with intellectual disabilities. The recipients were 18 men who had been diverted to the clinical psychology service for adults with intellectual disabilities from the criminal justice system. Thirteen participated in treatment and five refused it during assessment. Participants were followed up for 4 years after treatment. Of the 13 who completed treatment two re-offended. All five of the men who refused treatments re-offended. In view of the preliminary nature of these findings they are discussed in relation to methodological issues and future research.
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.
Development and implementation of a discharge pathway protocol for detained offenders with intellectual disabilities
- Authors:
- TAYLOR John L., et al
- Journal article citation:
- Journal of Intellectual Disabilities and Offending Behaviour, 8(3), 2017, pp.144-154.
- Publisher:
- Emerald
Purpose: Building the Right Support, a national plan for people with intellectual disabilities (ID) in England aims to avoid lengthy stays in hospital for such people. Discharge planning is understood to be helpful in facilitating successful transition from hospital to community services, however, there is little guidance available to help those working with detained patients with ID and offending histories to consider how to affect safe and effective discharges. The paper aims to discuss these issues. Design/methodology/approach: In this paper, the development and implementation of a multi-faceted and systemic approach to discharge preparation and planning is described. The impact of this intervention on a range of outcomes was assessed and the views of stakeholders on the process were sought. Findings: Initial outcome data provide support for the effectiveness of this intervention in terms of increased rates of discharge, reduced lengths of stay and low readmission rates. Stakeholders viewed the intervention as positive and beneficial in achieving timely discharge and effective post-discharge support. Practical implications: People with ID are more likely to be detained in hospital and spend more time in hospital following admission. A planned, coordinated and well managed approach to discharge planning can be helpful in facilitating timely and successful discharges with low risks of readmission. Originality/value: This is the first attempt to describe and evaluate a discharge planning intervention for detained offenders with ID. The intervention described appears to be a promising approach but further evaluation across a range of service settings is required. (Publisher abstract)
Making a difference? Ten years of managing people with intellectual disability and forensic needs in the community
- Authors:
- DE VILLIERS Jana, DOYLE Michael
- Journal article citation:
- Journal of Intellectual Disabilities and Offending Behaviour, 6(3/4), 2015, pp.165-174.
- Publisher:
- Emerald
Purpose: Nationally community services for patients with intellectual disability and forensic needs are limited, and research to guide service development for this patient group with highly complex needs is sparse. The purpose of this paper is to provide an overview of referrals to and case management by the multi-agency Fife Forensic Learning Disability Service (FFLDS), including demographic data, treatment, risk assessments and outcomes. Design/methodology/approach: All referrals received between 2004 and 2014 were reviewed to identify key demographic factors and to clarify the outcome of the referrals. Risks levels and presence of factors related to ongoing risk management were identified. For those accepted, final outcomes were noted. Findings: In total, 145 referrals were received by FFLDS between 1 January 2004 and 31 December 2014. Of these 117 were accepted for ongoing case management. In total 106 patients were discharged from FFLDS over the review period, with the vast majority remaining in community settings. Patients were overwhelmingly male, with an age range of 16-79 (mean age of 30). Approximately half of referrals were from criminal justice agencies, and sexual and violent offences predominated. Alcohol and/or illicit substance use was problematic in 49 per cent of patients. Research limitations/implications: FFLDS needs to consider building links with Drug and Alcohol Services, for assistance in developing expertise in managing problematic alcohol and/or illicit substance use. Links with professionals working with female offenders may increase the rate of referral of female patients. Originality/value: Policy and legal frameworks emphasise the need to manage people with learning disabilities and forensic needs in the least restrictive environment possible. This paper provides information on a cohort of forensic patients over a ten-year period, including characteristics and outcomes, to inform the evaluation of these frameworks and the planning of both community and in-patient services for this patient group. (Publisher abstract)
Cognitive-behavioural treatment of anger intensity among offenders with intellectual disabilities
- Authors:
- TAYLOR John L., et al
- Journal article citation:
- Journal of Applied Research in Intellectual Disabilities, 15(2), 2002, pp.151-165.
- Publisher:
- Wiley
Reports on a pilot study of an elaborated anger treatment protocol comparing the specialised anger treatment with routine care. Detained men with intellectual disabilities and histories of offending were allocated to specially modified cognitive-behavioural anger treatment or to routine care waiting-list control conditions. Treatment outcome was evaluated by participants' self-report of anger intensity to an inventory of provocations and by staff-ratings of the anger attributes of participants' ward behaviour. Participants' reported anger intensity was significantly lower following the anger treatment, compared to the routine care wait-list condition. Limited evidence for the effectiveness of anger treatment was provided by the staff ratings of participant behaviour post-treatment. Calls for further research to examine the mechanisms for change and their sustainability.