Home visits: a reflection on family contact in a specialist forensic intellectual disability service

Abstract

Purpose – There is little published literature about the number of home visits provided to patients within forensic intellectual disability units, and there is no published data on variables that affect home visits. There is a need for a baseline audit that can formulate standards for future practice. The paper aims to discuss these issues. Design/methodology/approach – This paper describes the home visit programme within a forensic intellectual disability service, and a baseline audit of the programme. The audit measured the number of home visits, any factors that adversely affect home visits, and the extent of family contact. The authors propose audit standards for evaluation of good practice in this area. Findings – The audit involved 63 patients over a one-year period. In total, 81 per cent of patients had some form of family contact and 54 per cent of patients at least one home visit. However, 19 per cent of patients had no contact with their family due to a variety of reasons. There were no significant differences in the number of home visits between men and women, patients on civil vs criminal sections or those treated “within area” or “out of area”. Patients in rehabilitation wards had significantly more visits than those in low or medium secure. Originality/value – Conventional wisdom is that reduced family contact is the direct result of patients being placed “out of area”. The results of this audit suggest that, at least in this group, the reasons may be much more nuanced and that the current definition of “out of area” has to be improved to incorporate the actual distance between the patient’s current family home and the service. Audit standards have been proposed to monitor family contact and home visits. Future work should focus on the relationship between family contact and treatment outcomes

A systematic review of in-patient psychiatric care for people with intellectual disabilities and/or autism: effectiveness, patient safety and experience

“…Four studies investigated aspects of the patient experience within forensic in-patient services. 21 , 23 , 59 , 129 A systematic review and Delphi study 21 identified patient and carer experience as an important indicator of service quality within in-patient forensic services for people with intellectual disabilities and/or autism. Three studies, excluding the systematic review by Morrissey et al, 21 investigated patient experience within in-patient forensic services, 23 , 59 , 129 with one focusing specifically on family and home visits.…”

“… 21 , 23 , 59 , 129 A systematic review and Delphi study 21 identified patient and carer experience as an important indicator of service quality within in-patient forensic services for people with intellectual disabilities and/or autism. Three studies, excluding the systematic review by Morrissey et al, 21 investigated patient experience within in-patient forensic services, 23 , 59 , 129 with one focusing specifically on family and home visits. 129 Two papers made use of semi-structured interviews and identified hospital admission as ‘helpful’, although the environment was characterised as ‘noisy’ and ‘stressful’, with both studies recognising loss of freedoms and restrictions of personal items as challenging for patients.…”

“…59 There was also evidence that family contact and home visits were frequent within low-secure, medium-secure and 'locked rehab' forensic services. 129 In-patient services for children and adolescents None of the eligible studies focused on the patient experience associated with admission to a psychiatric hospital for children and adolescents with intellectual disabilities and/or autism, or their families.…”

Treatment outcomes from forensic intellectual disability services: The perspectives of patients and their family/carers

“…Furthermore, only family carers actively in touch with their relative and engaged with services could be approached. Previous research has reported that approximately 20% of patients in FIDD services are not in any contact with relatives (Cheshire et al, 2015).…”

Defining quality of life for individuals with neurodevelopmental disorders: Challenges within an inpatient population

“…Relationships are important to the wellbeing of individuals’, including those with neurodevelopmental and mental disorders (Bishop-Fitzpatrick et al, 2017; Kilroy et al, 2014). However, challenges arise for people within this population due to the lack of opportunities to develop such relationships (Cheshire et al, 2015; Chinn et al, 2011).…”