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Services in the community for adults with psychosis and intellectual disabilities: a Delphi consultation of professionals' views
- Authors:
- HEMMINGS C.P., UNDERWOOD L.A., BOURAS N.
- Journal article citation:
- Journal of Intellectual Disability Research, 53(7), July 2009, pp.677-684.
- Publisher:
- Wiley
There remains a severe lack of evidence on the effectiveness of community services for adults with psychosis and intellectual disabilities (ID). There has been little consensus even of what services should provide for this service user group. A consultation of multidisciplinary professionals was carried out by using a three-round Delphi exercise. Participants were recruited nationally. They rated their views on the importance of 139 items for the care of adults with psychosis and ID. These included 85 routine service components, 23 service user characteristics for those needing a more intensive service and 31 more intensive service components. Forty-nine out of 52 participants completed all three rounds of the Delphi consultation. Consensus of opinion (≥80% agreement as essential) was obtained on 18 of the routine service components, nine of the service user characteristics and five of the more intensive service components. The routine service components considered essential can be broadly considered under a need for a focused approach on the service user and their illness (e.g. monitoring of mental state) and the added need to work within the wider context of the service user with psychosis and ID (e.g. access to social, leisure or occupational activities). Five of the more intensive service components were considered to be essential (e.g. can react to a crisis that day). However, the routine service components considered essential already contained many components such as out-of-hours support and crisis plans also relevant to more intensive services. the authors conclude that these findings can be used to develop further the evidence base for services in the community for this user group and to assist in the preparation of much needed service evaluation studies.
Comparison of adults with intellectual disabilities and mental health problems admitted to specialist and generic inpatient units
- Authors:
- HEMMINGS C.P., et al
- Journal article citation:
- British Journal of Learning Disabilities, 37(2), June 2009, pp.123-128.
- Publisher:
- Wiley
This study aimed to compare the characteristics of service users with intellectual disabilities and mental health problems admitted to either a specialist or a generic inpatient unit in an area of South London. Socio-demographic and clinical characteristics of consecutive admissions over a 5.5-year period were recorded using a questionnaire. Key differences in psychiatric diagnosis, residence type and discharge destination were found between individuals using generic and specialist provision. Length of stay was significantly longer for specialist unit admissions. Admissions to the specialist unit were significantly more likely to reside with family prior to admission and admissions to generic units were significantly more likely to come from 'other' forms of residence such as hostels, prison and 'no fixed abode'. At discharge the proportion of those admitted to the specialist unit who resided with their families reduced. At the same time the proportion of those living in supported accommodation increased although compared with those admitted to generic units they were still significantly more likely to return to the family home. Significantly, more adults admitted to generic units were diagnosed with an affective disorder. Specialist inpatient provision may be crucial in helping mainstream services meet the needs of individuals with intellectual disabilities and mental health problems.