Search results for ‘Subject term:"learning disabilities"’ Sort:
Results 1 - 10 of 14
New legislative proposals for women with learning disabilities and mental health problems
- Authors:
- McNAMARA Eileen, HALL Ian
- Journal article citation:
- Tizard Learning Disability Review, 9(4), October 2004, pp.36-40.
- Publisher:
- Emerald
Several proposed changes to the law in England and Wales will particularly affect women with learning disabilities. The Sexual Offences Act 2003 and the draft Mental Health and Mental Incapacity Bills all highlight the tension between state paternalism and individual autonomy. Uses a fictional case scenario to consider the practical implications of the proposed legislation, and dilemmas that may arise.
Secure inpatient services: a needs assessment
- Authors:
- HALL Ian, et al
- Journal article citation:
- Journal of Intellectual Disabilities and Offending Behaviour, 5(1), 2014, pp.38-53.
- Publisher:
- Emerald
Purpose: The purpose of this paper is to complete a thorough needs assessment that would enable the development of a robust pathway of care for adults with a learning disability requiring secure care, and to assist commissioners to make informed planning decisions. Design/methodology/approach: The paper identified people with a learning disability originating from London who were in secure care, and collected data about them. The paper used reference groups to inform the analysis. Findings: The paper identified 249 people in secure services and was able to include 136 patients in the analysis. In all, 64 were in NHS provision and 72 in independent sector provision; 109 (80.1 per cent) were male and 27 (19.9 per cent) female; on average, patients were cared for 61.5 miles away from their homes; NHS patients were far closer to home; 69.1 per cent had a mild learning disability; 82.3 per cent had a history of violence; approximately one in six patients could not progress due to a lack of an appropriate ward, facility, resource and/or intervention. Practical implications: Secure care for this population is a major public health issue. Many are placed a long way from home. Local services should be developed, and there should be sufficiently robust “step down” places for patients to be discharged to. Originality/value: Systematic identification of the needs of a marginalised group to enable better more appropriate care pathways to be developed in the future. (Publisher abstract)
The sexual lives of men with mild learning disability: a qualitative study
- Authors:
- YACOUB Evan, HALL Ian
- Journal article citation:
- British Journal of Learning Disabilities, 37(1), March 2009, pp.5-11.
- Publisher:
- Wiley
This study aimed to explore the sexual lives and behaviour of men with mild learning disabilities living both in community and in secure hospital settings. Narrative interviews that focused on areas such as relationships, sex education, contraception and the attitudes of others towards the participants' sexual lives and orientation were used. Several clients reported engaging in unsafe practices despite being aware of the risks. Participants generally felt that services had shifted from a paternalistic to a more supportive approach towards their sexual lives and orientation. Experiences with other men were commonly reported. Several participants reported being pressurised into sex as adults. In the sample, sexual knowledge did not lead to safe sexual practices. The good rapport with services reported by the participants may be utilised to provide further education and empowerment to improve the safety of sexual practices in this group. Other ways of improved service delivery are suggested.
Secure in-patient services for people with learning disability: is the market serving the user well?
- Authors:
- YACOUB Evan, HALL Ian, BERNAL Jane
- Journal article citation:
- Psychiatric Bulletin, 32(6), June 2008, pp.205-207.
- Publisher:
- Royal College of Psychiatrists
Psychiatrists can help in the development of better local services for people with learning disability by clearly defining the client group and their needs, involvement in the process of commissioning such services, and learning from colleagues in other service areas such as forensic psychiatry. This should help enable people with learning disability with very high needs to have similar access to services as others have.
The development of a new integrated mental health service for people with learning disabilities
- Authors:
- HALL Ian, et al
- Journal article citation:
- British Journal of Learning Disabilities, 34(2), June 2006, pp.82-87.
- Publisher:
- Wiley
It is now well recognized that people with learning disabilities experience the full range of psychiatric disorders. Public policy in the United Kingdom advocates that people with learning disabilities should access mainstream mental health services. The authors discuss the challenges this policy presents, and then describe the processes they went through to set up a service that properly enabled such access. They describe the service model in some detail, then reflect on overcoming barriers to implementation, and how we maintain the service model. Finally some lessons for future service development initiatives are highlighted.
The place of medication for challenging behaviour: a whole system perspective
- Authors:
- BAMIDELE Kunle, HALL Ian
- Journal article citation:
- Advances in Mental Health and Intellectual Disabilities, 7(6), 2013, pp.325-332.
- Publisher:
- Emerald
This article explores the place of medication in the management of challenging behaviour in people with intellectual disability by considering it in the context of the whole system around the person and by considering the challenges of implementing best practice guidance. The article identifies factors that are barriers to implementing appropriate best clinical practice guidelines (such as “Challenging behaviour: a unified approach”) in relation to medication intervention. It also explores current policy and recommendations on how to improve services for people with intellectual disability and challenging behaviour and make suggestions about how to ensure better compliance with existing guidelines and improve service delivery. Better integration of services, access to specialist interventions including applied behavioural analysis and understanding communication are all essential to reducing the use of medication, as is the need for reactive, personalised and skilled social care provision. (Edited publisher abstract)
Secure inpatient services for people with intellectual disability: lessons from developing a new service
- Authors:
- HALL Ian, YACOUB Evan, YUSUFI Babur
- Journal article citation:
- Advances in Mental Health and Intellectual Disabilities, 4(4), December 2010, pp.15-24.
- Publisher:
- Emerald
Secure inpatient services for people with intellectual disability are provided in a piecemeal way, often without strategic commissioning. Such people are often placed in remote and costly units because suitable local facilities do not exist. This article describes the development of a new secure inpatient service led by the local NHS foundation trust for men with intellectual disability who often had substantial additional mental health needs. In particular, the article describes the needs assessment of 27 people using specialist inpatient services who originated from the local service area, which comprised 4 inner London boroughs. Consulting with all stakeholders was found to be essential, with the service user and family perspectives particularly helpful. The finding of this service development project were: that foundation trusts that are able to develop services at financial risk, before contracts are signed, enabled development to take place at a faster pace; good relationships with community teams are essential, as is true integration with mainstream forensic services; and maintaining a relationship with commissioners was a particularly challenging aspect, perhaps because the development was provider-led. Despite these challenges, the new service has enabled many people with intellectual disability with very high needs to be supported much nearer to home.
Making care programme approach meetings more accessible and person-centred for people with learning disabilities
- Authors:
- HALL Ian, et al
- Journal article citation:
- Advances in Mental Health and Learning Disabilities, 3(1), March 2009, pp.23-29.
- Publisher:
- Emerald
The care programme approach (CPA) is an important part of supporting people with mental health problems in the community and has been applied with variable success in services for people with learning disabilities. Investigation into service users' understanding of the CPA has been limited. This study employed multiple methodologies to explore what service users with learning disabilities and additional mental health problems thought about the CPA process, and what their understanding of it was. The authors used the findings to work with other professionals to adapt the meetings in a way that was accessible and inclusive. This work was included in the service communication plan and produced guidance for care co-ordinators and materials to be used at the meetings. The guidance and materials can be used by any service and will be available online.
Sex, relationships and the law for people with learning disability
- Authors:
- HALL Ian, YACOUB Evan
- Journal article citation:
- Advances in Mental Health and Learning Disabilities, 2(2), June 2008, pp.19-24.
- Publisher:
- Emerald
This article reviews the policy, legislation and literature on sex and relationships for people with learning disability, through a search of electronic databases, journals and other resources. It reviews the rights of people with learning disabilities to a sexual life and their views of service responses, sexual offences legislation and the link between sexual knowledge and practice. It also explores sexual orientation and preference among people with learning disabilities, differences between the genders and sexual offending, including consideration of 'victimless' offences. It concludes that the balance between empowering and protecting people with learning disabilities is challenging but important.
Challenges in accessing local services for a person with complex mental health needs: a network approach
- Authors:
- HASSIOTIS Angela, PARKES Charles, HALL Ian
- Journal article citation:
- Advances in Mental Health and Learning Disabilities, 1(1), March 2007, pp.42-44.
- Publisher:
- Emerald
This case study of a women with moderate learning disabilities, autistic traits and bipolar affective disorder illustrates the challenges of supporting people with learning disabilities in community settings during and acute episode of mental illness. She was admitted to a generic in-patient psychiatric service, and the way in which her links with her home and community were maintained are described. The difficulty of transferring and maintaining behavioural guidelines form the in-patient to a community setting are discussed. The delay in effecting a discharge necessitated her admission to a specialist unit for people with learning disabilities outside the local areas. The possible reasons and solutions for this scenario are debated.