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“Why can’t they be in the community?” a policy and practice analysis of transforming care for offenders with intellectual disability
- Authors:
- ALEXANDER Regi T., et al
- Journal article citation:
- Advances in Mental Health and Intellectual Disabilities, 9(3), 2015, pp.139-148.
- Publisher:
- Emerald
Purpose: The purpose of this paper is to describe key policy and practice issues regarding a significant subgroup of people with intellectual disability – those with offending behaviour being treated in forensic hospitals. Design/methodology/approach: The reasons why psychiatrists continue to be involved in the treatment of people with intellectual disability and mental health or behavioural problems and the factors that may lead to patients needing hospital admission are examined. Using two illustrative examples, three key questions – containment vs treatment, hospital care vs conditional discharge and hospital treatment vs using deprivation of liberty safeguards usage in the community are explored. Findings: Patients with intellectual disability, mental health problems and offending behaviours who are treated within forensic inpatient units tend to have long lengths of stay. The key variable that mediates this length of stay is the risk that they pose to themselves or others. Clinicians work within the framework of mental health law and have to be mindful that pragmatic solutions to hasten discharge into the community may not fall within the law. Originality/value: This paper makes practical suggestions for the future on how to best integrate hospital and community care for people with intellectual disability, mental health and offending behaviours. (Publisher abstract)
A five decade retrospective review of admission trends in a NHS intellectual disability hospital
- Authors:
- WONG Yim Lun, et al
- Journal article citation:
- Advances in Mental Health and Intellectual Disabilities, 9(3), 2015, pp.108-115.
- Publisher:
- Emerald
Purpose: The purpose of this paper is to examine the trend of admissions and inpatient characteristics in a NHS intellectual disability hospital from 1975 to 2013, in particular looking at the effect following the Winterbourne View scandal. Design/methodology/approach: A retrospective review of all admissions over a three-year period (January 2011-January 2013) was completed. This information was compared with admissions to the same hospital in three-year period over the last four decades (1975-1977, 1985-1987, 1995-1997, and 2003-2006). Number of admissions, gender, age, source of admission, length of stay, reasons for admission, type of admission, and diagnosis of psychiatric illnesses were included. Findings: There were 87 admissions (including 29 from out of area) in the study period of 2011-2013. The number of admissions had varied over the years but male admissions were consistently higher than female. A majority of people stayed over six months. For the first time in five decades, there were more formal inpatients than informal ones. The diagnosis of Autism Spectrum Disorder (ASD) and of Attention Deficit Hyperactivity Disorder had increased. Originality/value: This study has examined admission trends over five decades. It has highlighted that the Mental Health Act legislation is being used more frequently and that co-morbid mental disorders, such as ASD are commonly associated with those admitted to hospital. A well planned-out community health care system, as well as adequate social provision are keys to maintain people with intellectual disability in the community. Furthermore, a better understanding of the symptomology of challenging behaviours, and appropriate use of mental health legislation are crucial in providing a high-quality service that has clear treatment goals and values. Some of these issues have contributed to the failure of the recent initiative to reduce the size of the inpatient intellectual disability following Winterbourne View scandal. (Publisher abstract)
Court of appeal ruling on unlawful detention: R v Bournewood Community and Mental Health NHS Trust ex p L. CA (1998) 1AllER 634
- Author:
- BRAMMER Alison
- Journal article citation:
- Tizard Learning Disability Review, 3(3), July 1998, pp.28-31.
- Publisher:
- Emerald
Reports on a recent Court of Appeal decision which ruled that where a persons is admitted to hospital on an 'informal' basis, but is unable to give valid consent to admission, then it is an unlawful detention.
Flawed law
- Authors:
- KINTON Mat, ROBINSON Robert
- Journal article citation:
- Mental Health Care, 1(12), August 1998, pp.398-399.
- Publisher:
- Pavilion
In June a House of Lords ruling restored the previous interpretation of the law on admission and treatment of mentally incapacitated adults. The authors, one from the Mental Health Act Commission and the other a solicitor, unravel the complexities of the Bournewood case.
Time to decide who decides
- Author:
- HOLMAN Andrew
- Journal article citation:
- Community Living, 12(1), July 1998, pp.22-23.
- Publisher:
- Hexagon Publishing
People with learning difficulties are being increasingly affected by legislation about consent. Reviews the recent Bournewood case and outlines some proposals for a better system which have been presented to the Lord Chancellor as part of the consultation exercise on the Green Paper, 'Who Decides?'