Tiered model of learning disability forensic service provision

2012 ◽  
Vol 3 (4) ◽  
pp. 175-185 ◽  
Author(s):  
John Devapriam ◽  
Regi T. Alexander
Dementia ◽  
2018 ◽  
Vol 19 (3) ◽  
pp. 736-749 ◽  
Author(s):  
Karen McKenzie ◽  
Dale Metcalfe ◽  
Amanda Michie ◽  
George Murray

This research aimed to identify current national provision by health services in Scotland in relation to proactive screening and reactive assessment for people with an intellectual disability in Scotland who have, or are at risk of developing, dementia. Staff from 12 intellectual disability services, representing the 11 health board areas in Scotland, completed an online questionnaire which asked about proactive screening and reactive assessment for people with intellectual disability who had, or were at risk of developing, dementia as well as suggested areas for improvement. All of the areas provided services for people with intellectual disability who have, or are at risk of developing, dementia, but differed as to whether this was reactive, proactive or both. Nine services offered intervention following diagnosis. The most common elements used across both proactive screening and reactive assessment were conducting a health check, using a general dementia questionnaire designed for people with an intellectual disability and direct assessment with the person. Clinical psychology and community learning disability nurses were the professions most likely to be involved routinely in both proactive screening and reactive assessments. The psychometric properties of the most commonly used assessments of cognitive and behavioural functioning were mixed. The areas of improvement suggested by practitioners mainly related to ways of improving existing pathways. This research represents the first step in providing an overview of service provision in Scotland. There was some inconsistency in relation to the general and specific components which were involved in proactive screening and reactive assessment. Implications for service provision are discussed.


Author(s):  
P. McIntosh

Joint training and practice in the field of learning disability is a growing phenomenon. This paper offers a philosophical basis to a debate on the representation of the concept of interprofessionalism. It takes a broad view, looking at professional culture, user participation, professional and personhood values and locations of power in order to present a ‘genealogy’ in the complexity of service provision. Arguments are made to develop an empirical base in order to further understand joint practices and thought, particularly around the language and meaning of the concept of collaboration.


2002 ◽  
Vol 4 (2) ◽  
pp. 29-33 ◽  
Author(s):  
Regi Alexander ◽  
Jack Piachaud ◽  
Lola Odebiyi ◽  
Satheesh Gangadharan

2004 ◽  
Vol 6 (4) ◽  
pp. 10-20 ◽  
Author(s):  
Elizabeth Berber ◽  
Harm Boer

In recent years there has been growing interest in the fate of those women with mental disorder who come into contact with the criminal justice system. This interest has stemmed from growing recognition that traditional forensic services could not offer the appropriate care required by this group in a conventional mixed‐gender environment. Women‐only services have begun to be developed in generic psychiatric settings, spurred on by the national service framework (NSF) which set a time limit for the development of segregated in‐patient facilities. Forensic services for those with learning disability have been slower to take up the challenge of how best to place women with learning disability who offend and require an in‐patient secure environment. This article describes how one such service attempted to rise to this challenge and build a service for this often neglected group


Author(s):  
Anna Leonie Wark

Purpose Legislative guidance stipulates that people with a learning disability have the right to receive local provision of personalised support within the least restrictive environment. On these bases there is a growing emphasis on the requirement for local authorities to develop appropriate services for people who are currently in a hospital setting. The purpose of this paper is to examine the literature addressing factors influencing the provision of effective community-based forensic services. Design/methodology/approach The six articles were analysed separately using the evaluation tool – Currency, Relevance, Authority, Accuracy, Purpose. The six articles used divergent sample groups and employed both qualitative and quantitative methods to collate data. The articles shared a purpose of examining forensic community service provision with an aim to improve services. Findings There were three themes that emerged consistently across the literature these included: balancing risk management vs individual autonomy; multi-disciplinary and multi-agency working; service improvement. There is a growing emphasis on the need to replace long-term hospital placements with specialist, community provision, employing least restrictive methods and positive responses to crisis situations. In this climate, it is crucial that multi-disciplinary agencies from local authority, health and the charitable and private sector continue to work collaboratively on the integration of service provision in order to bring about the development of effective and responsive community services. Research limitations/implications Research limited to peer reviewed and published research papers focusing on the subject of community forensic services with publications specifically made within the time frame of the Transforming Care Agenda. Practical implications This paper looks to examine the practical solutions to providing effective community forensic services for a person with an intellectual disability and makes recommendations for research into improving service specific training for support staff. Social implications Following the Winterbourne View Hospital scandal (BBC One, 2011) instigations were made to make legislative change under the Transforming Care Agenda. Despite a renewed conviction in the rights of people to be a part of their local community without segregation or discrimination, professionals in the field continue to report a failure to reduce numbers of people in long stay hospitals and secure settings. With commissioning under pressure to make these intentions a reality it is a really good time to reflect on practice and evaluate service models to establish the factors that bring about positive outcomes for individuals enabling inclusion within community settings. Originality/value This review will focus on the literature evidencing positive intervention and outcome focussed methods of supporting people with a forensic history in the community. This is an entirely original piece of work analysing peer reviewed and published research.


2020 ◽  
Vol 25 (1) ◽  
pp. 47-52
Author(s):  
Becky Hardiman

Purpose The purpose of this study is to reflect on some of the challenges faced by caregivers when making decisions relating to school placements for their child with a learning disability. Design/methodology/approach Quotes from parents and caregivers, contacted via a national syndrome support charity, are shared, along with broader perspectives gained through the charity’s helpline service. Findings A number of themes are discussed, including friendships and role models; expectations and educational targets; training, speciality and capacity of staff and managing a widening gap. Originality/value When considering the future of education provision, it is important to consider some of the tensions between an ideology of inclusion and the current realities of service provision. To create effective solutions to achieving more effective inclusion, the concerns and experiences of families, as well as children, must be considered.


2002 ◽  
Vol 26 (8) ◽  
pp. 299-301 ◽  
Author(s):  
R. Alexander ◽  
A. Regan ◽  
S. Gangadharan ◽  
S. Bhaumik

Aims and MethodA postal survey was sent to all consultants in the psychiatry of learning disability from four English regions. Their views on job satisfaction, their core roles and the management re-structuring of services were elicited.ResultsThe proportion agreeing or strongly agreeing with each management option was 79% for integrated mental health–learning disability trusts, 61% for specialist learning disability trusts, 47% for care trusts, 10% for primary care trusts and 5% for social services. Only 34% felt consulted or able to influence the process of change and only 33% were satisfied with the current management changes within their trust but 67% were satisfied overall with their jobs.Clinical ImplicationsManagement from integrated mental health–learning disability trusts is the most preferred option for psychiatrists in learning disability. A large number of consultants, though otherwise satisfied with their jobs, feel excluded or unable to influence the current changes in management structures. A model of integrated service provision in line with the government's learning disability strategy is presented.


2003 ◽  
Vol 9 (5) ◽  
pp. 368-373 ◽  
Author(s):  
Angela Hassiotis ◽  
Peter Tyrer ◽  
Patricia Oliver

Assertive outreach is a well-established method of managing patients with severe mental illness in the community. However, there is limited application and evidence of its efficacy in services for people with learning disabilities who also have mental illness. This paper elucidates current service provision for this group of patients and illustrates the pathways to mental health care available to them.


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