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3 results

  • Chapter 15 - Management of Violence in People With Intellectual Disability

  • from Section 4 - Management in Other Groups
  • Edited by Masum Khwaja, Imperial College of Science, Technology and Medicine, London, Peter Tyrer, Imperial College of Science, Technology and Medicine, London
  • Book:
    The Prevention and Management of Violence
    Published online:
    09 May 2023
    Print publication:
    11 May 2023, pp 248-259

  • Summary

    Violent behaviour displayed by individuals with intellectual disability (ID) is one of the biggest challenges to services. It can cause serious consequences to the health and well-being of the individual and those involved in their care, including exclusion from services or social groups. There is a greater risk of violence in the ID population and aetiological causes include biological and psychosocial factors and developmental disorders such as ASD and ADHD. Key management strategies involve a review of these factors, robust risk assessments and collaborative working utilising a multidisciplinary approach. Psychological and behavioural support interventions offered should be person-centred and tailored according to their needs. The goal is to assess and modify psychological, environmental or social factors and improve challenging behaviour. Pharmacological treatment can be helpful where underlying physical or mental health illnesses contribute to aggression. In those without obvious causes of violent behaviour, psychotropic medication can be also used to attenuate risks; however, current evidence base is limited and medication options should be considered on a case-by-case basis.

  • Delivering the Transforming Care programme: a case of smoke and mirrors?

  • John L. Taylor
  • Journal:
    BJPsych Bulletin / Volume 43 / Issue 5 / October 2019
    Published online by Cambridge University Press:
    21 February 2019, pp. 201-203
    Print publication:
    October 2019
    • Article
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      • Open access
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  • The Transforming Care national plan for England to develop community services and close hospital beds for people with intellectual disabilities and/or autism was published in October 2015 and is due to finish in March 2019. In this editorial the key plan objectives are evaluated, with particular reference to people with intellectual disabilities and/or autism who offend or are at risk of offending. The conclusion is that, to date, the plan has failed to meet its targets to reduce the number of in-patients with intellectual disabilities and/or autism and to invest in community services, and the number of patients in independent sector beds is increasing.

  • Long-stay patients with and without intellectual disability in forensic psychiatric settings: comparison of characteristics and needs

  • Verity Chester, Birgit Völlm, Samuel Tromans, Chaya Kapugama, Regi T. Alexander
  • Journal:
    BJPsych Open / Volume 4 / Issue 4 / July 2018
    Published online by Cambridge University Press:
    28 June 2018, pp. 226-234
    • Article
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      • Open access
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  • Background

    In recent years, concerns have been raised that too many patients stay for too long in forensic psychiatric services and that this is a particular problem in those with an intellectual disability.

    Aims

    To compare the characteristics, needs, and care pathways of long-stay patients with and without intellectual disability within forensic psychiatric hospital settings in England.

    Method

    File reviews and questionnaires were completed for all long-stay patients in high secure and a representative sample of those in medium secure settings in England. Between-group analyses comparing patients with and without intellectual disability are reported.

    Results

    Of the 401 long-stay patients, the intellectual disability and non-intellectual disability groups were strikingly similar on many sociodemographic, clinical and forensic variables. The intellectual disability group had significantly lower lengths of stay, fewer criminal sections, restriction orders and prison transfers, and higher levels of behavioural incidents and risk assessment scores.

    Conclusions

    In spite of similar offence histories and higher risk levels, those with intellectual disability appear to be diverted away from the criminal justice system and have shorter lengths of stay. This has implications about the applicability of the Transforming Care programme to this group.