“Why can’t they be in the community?” A policy and practice analysis of transforming care for offenders with intellectual disability

Alexander, Regi; Devapriam, John; Michael, Dasari; McCarthy, Jane; Chester, Verity; Rai, Rahul; Naseem, Aezad; Roy, Ashok

doi:10.1108/amhid-02-2015-0011

Cited by 28 publications

(40 citation statements)

References 17 publications

(19 reference statements)

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“…Alexander et al 106 ), and most studies have found that severe mental illness was associated with longer and PD with shorter LoS (e.g. Shah et al 42 ).…”

Section: Factors Associated With Length Of Staymentioning

confidence: 99%

A mixed-methods study exploring the characteristics and needs of long-stay patients in high and medium secure settings in England: implications for service organisation

Völlm

Edworthy

Holley

et al. 2017

Health Serv Deliv Res

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, et al. A mixed-methods study exploring the characteristics and needs of long-stay patients in high and medium secure settings in England: implications for service organisation. Health Serv Deliv Res 2017;5(11). Health Services and Delivery ResearchISSN 2050-4349 (Print) ISSN 2050-4357 (Online) This journal is a member of and subscribes to the principles of the Committee on Publication Ethics (COPE) (www.publicationethics.org/).Editorial contact: nihredit@southampton.ac.ukThe full HS&DR archive is freely available to view online at www.journalslibrary.nihr.ac.uk/hsdr. Print-on-demand copies can be purchased from the report pages of the NIHR Journals Library website: www.journalslibrary.nihr.ac.uk Criteria for inclusion in the Health Services and Delivery Research journalReports are published in Health Services and Delivery Research (HS&DR) if (1) they have resulted from work for the HS&DR programme or programmes which preceded the HS&DR programme, and (2) they are of a sufficiently high scientific quality as assessed by the reviewers and editors. HS&DR programmeThe Health Services and Delivery Research (HS&DR) programme, part of the National Institute for Health Research (NIHR), was established to fund a broad range of research. It combines the strengths and contributions of two previous NIHR research programmes: the Health Services Research (HSR) programme and the Service Delivery and Organisation (SDO) programme, which were merged in January 2012.The HS&DR programme aims to produce rigorous and relevant evidence on the quality, access and organisation of health services including costs and outcomes, as well as research on implementation. The programme will enhance the strategic focus on research that matters to the NHS and is keen to support ambitious evaluative research to improve health services.For more information about the HS&DR programme please visit the website: http://www.nets.nihr.ac.uk/programmes/hsdr This reportThe research reported in this issue of the journal was funded by the HS&DR programme or one of its preceding programmes as project number 11/1024/06. The contractual start date was in March 2013. The final report began editorial review in March 2016 and was accepted for publication in September 2016. The authors have been wholly responsible for all data collection, analysis and interpretation, and for writing up their work. The HS&DR editors and production house have tried to ensure the accuracy of the authors' report and would like to thank the reviewers for their constructive comments on the final report document. However, they do not accept liability for damages or losses arising from material published in this report.This report presents independent research funded by the National Institute for Health Research (NIHR). The views and opinions expressed by authors in this publication are those of the authors and do not necessarily reflect those of the NHS, the NIHR, NETSCC, the HS&DR programme or the Department of Health. If there are verbatim quotations included in this publication the ...

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“…Alexander et al 106 ), and most studies have found that severe mental illness was associated with longer and PD with shorter LoS (e.g. Shah et al 42 ).…”

Section: Factors Associated With Length Of Staymentioning

confidence: 99%

A mixed-methods study exploring the characteristics and needs of long-stay patients in high and medium secure settings in England: implications for service organisation

Völlm

Edworthy

Holley

et al. 2017

Health Serv Deliv Res

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“…A number of authors have suggested that a lack of secure services for LD patients might contribute to their higher LoS [28] and most studies have found that severe mental illness was associated with longer and PD with shorter LoS [11]. This study did not use formal diagnostic data, but diagnostic ward type was used as a proxy and reflects these findings.…”

Section: Discussionmentioning

confidence: 99%

Long-stay in forensic-psychiatric care in the UK

Hare-Duke

Furtado

Guo

et al. 2018

Soc Psychiatry Psychiatr Epidemiol

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PurposeForensic services provide care for mentally disordered offenders. In England this is provided at three levels of security—low, medium and high. Significant number of patients within these settings remain detained for protracted periods of time. This is both very costly and restrictive for individuals. No national studies have been conducted on this subject in England.MethodsWe employed a cross-sectional design using anonymised data from medical records departments in English secure forensic units. Data were collected from a large sample of medium secure patients (n = 1572) as well as the total high secure patient population (n = 715) resident on the census date (01-04-2013). We defined long-stay as a stay of more than 10 years in high, 5 years in medium or 15 years in a mix of high and medium secure settings. Long-stay status was assessed against patient demographic and admission information.ResultsWe identified a significant proportion of long-stayers: 23.5% in high secure and 18.1% in medium secure care. Amongst medium secure units a large variation in long-stay prevalence was observed from 0 to 50%. Results indicated that MHA section, admission source and current ward type were independent factors associated with long-stay status.ConclusionThis study identified a significant proportion of long-stayers in forensic settings in England. Sociodemographic factors identified in studies in individual settings may be less important than previously thought. The large variation in prevalence of long-stayers observed in the medium secure sample warrants further investigation.

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“…The needs of people autism with or without intellectual disabilities with behaviour that challenges (who should be wholly supported in their own home) are different to the needs of those with additional mental illness; who may also require hospital treatment in the same way that the general population would according to the severity of their illness (Alexander et al, 2015). This distinction is important as people with behaviour that challenges or Autism alone should not be in hospital and it is absolutely right that we have policies that aim to end this practice, however people with intellectual disabilities or Autism with mental illness will on occasion require a specialist hospital admission in an ATU due to the relapsing and remitting nature of mental illness and the complications associated with an intellectual disability (RCP Faculty of Psychiatry of Intellectual Disability, 2013, pp.…”

Section: Discussionmentioning

confidence: 99%

Is “transforming care” failing people with autism?

Marshall-Tate

Chaplin

McCarthy

2017

AIA

Self Cite

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Purpose -The purpose of this paper is to comment on the development and implementation of transforming care (TC) and whether it has failed people with autism. Design/methodology/approach -This paper is a commentary.Findings -The number of people with autism being admitted to assessment and treatment units is increasing despite the aims of TC. The authors argue that TC, in serving such a diverse group of people, may have failed to identify the heterogeneity of such groups or recognise the different needs of people with mental illness and people with behaviours that challenge; and that TC could be regarded as a policy that only affects people with an intellectual disability. Originality/valuePolicymakers, policy implementers and health and social care staff may consider reviewing their practice to ensure that TC works for people with autism and their family and carers.

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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

Abstract: Advances in Mental Health and Intellectual DisabilitiesPurpose: This paper describes key policy and practice issues regarding a significant subgroup of people with intellectual disability -those with offending behaviour being treated in forensic hospitals.

Cited by 28 publications

References 17 publications

A mixed-methods study exploring the characteristics and needs of long-stay patients in high and medium secure settings in England: implications for service organisation

A mixed-methods study exploring the characteristics and needs of long-stay patients in high and medium secure settings in England: implications for service organisation

Long-stay in forensic-psychiatric care in the UK

Is “transforming care” failing people with autism?

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