Application of community treatment orders (CTOs) in adults with intellectual disability and mental disorders

2015 ◽  
Vol 9 (4) ◽  
pp. 196-205
Author(s):  
Jaya Gupta ◽  
Angela Hassiotis ◽  
Ingrid Bohnen ◽  
Yogesh Thakker
Keyword(s):  
Intellectual Disability ◽  
Clinical Practice ◽  
Mental Disorders ◽  
Mental Health Problems ◽  
Civil Liberties ◽  
Community Treatment ◽  
National Study ◽  
Community Treatment Orders ◽  
Content Type ◽  
White Males

Purpose – The purpose of this paper is to explore use of community treatment orders (CTOs) in adults with intellectual disability (ID) and mental health problems across England and Wales. Design/methodology/approach – A web-based exploratory survey was sent to 359 consultants on the database of the Faculty of the Psychiatry of ID, Royal College of Psychiatrists who had declared ID as their main speciality. Socio-demographic details of responding consultants, clinical characteristics of adults with ID on CTO, subjective views of consultants on using CTOs in people with ID were collected and analysed. Findings – In total, 94 consultant questionnaires were returned providing information on 115 patients detained under CTO. More than 75 per cent of the respondents had used CTO in their clinical practice. Patients subject to CTO were generally young, white males with mild ID and living in supported accommodation. CTOs were primarily used in situations of non-engagement (52.2 per cent), non-compliance with medication (47 per cent) or non-compliance with social care supports (49.6 per cent). Practical implications – Responding consultants expressed concerns about encroachment of civil liberties and ethics of using CTOs in people with ID who may lack capacity and stressed that decision to use CTOs needs to be therefore done on individual basis. Originality/value – This is the first national study to examine the practice of applying CTOs in adults with ID and mental disorders. Current practice is based on evidence from research done in adults with normal intelligence. Further research is needed to investigate the utility of CTOs in routine clinical practice in adults with ID and mental disorders.

Mind Matters: a psychoeducation programme for individuals with intellectual disabilities and co-morbid diagnoses of mental disorder

2017 ◽  
Vol 8 (1) ◽  
pp. 34-40 ◽  
Author(s):  
Sarah Ashworth ◽  
Krista Jansen ◽  
Lydia Bullock ◽  
Paul Mooney
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Intellectual Disability ◽  
Personality Disorder ◽  
Mental Disorders ◽  
Mental Disorder ◽  
Intellectual Disabilities ◽  
Psychological Intervention ◽  
Content Type ◽  
Group Members

Purpose The purpose of this paper is to describe a feasibility study into the development and pilot of a psychoeducational group for people with intellectual disability and co-morbid mental disorder (including mental illness and personality disorder) within forensic settings. Design/methodology/approach “Mind Matters”, a psychoeducational programme for people with an intellectual disability and co-morbid mental disorders is a group based programme in a medium secure hospital, adapted and developed to be suitable for people with intellectual disability therapist multidisciplinary approach was key to its development. An open group on a 16-bedded ward for individuals with mild to moderate intellectual disability and co-morbid mental illness was delivered over a six-week period. Findings The group was positively received in pilot by participants and members of the clinical teams. Attendance and engagement of participants were key measures of the success of the programme. In addition to the apparent increased social skills and motivation to engage with future psychological intervention. Practical implications The authors believe that this approach benefitted both the group members and staff on ward, reinforcing strategies for maintaining positive mental health. It also stimulated engagement, discussion about mental disorders including mental illness, personality disorder and intellectual disabilities. Originality/value This paper shows how a psychoeducational approach to mental disorder and mental health in individuals with an intellectual disability is possible, beneficial and well received.

Mental health and intellectual disability: integrating different approaches in the neurodevelopmental perspective

2015 ◽  
Vol 9 (5) ◽  
pp. 217-221
Author(s):  
Marco O. Bertelli
Keyword(s):  
Mental Health ◽  
Intellectual Disability ◽  
Time Course ◽  
Mental Health Problems ◽  
Developmental Time ◽  
Autism Spectrum ◽  
International Congress ◽  
Content Type ◽  
Perspective Drawing ◽  
Interdisciplinary Approaches

Purpose – The purpose of this paper is to provide a critical overview of some main implications of the neurodevelopmental perspective for the field of the mental health in intellectual disability and autism spectrum disorders. Design/methodology/approach – A discussion surrounding the importance of integrating different approaches in the neurodevelopmental perspective, drawing on sources from the paper proposals to the 10th International Congress of the European Association in Mental Health and Intellectual Disability (EAMHID), and the literature. Findings – At present, the neurodevelopmental perspective seems to be the most appropriate and valued conceptual framework to support multi-level, interdisciplinary approaches in understanding the aetiologies of mental health problems as well as when and how to intervene. It inherently exemplifies a dimensional approach, which can capture variations between individuals, their developmental time course, brain-behaviours associations and functional significance better than categorical approaches, and diagnostic measures. Originality/value – This editorial outlines a special issue that offers a comprehensive and varied collection of papers from the contributions to the 10th International Congress of the EAMHID.

Community Treatment Orders in Victoria: A Clinico-Ethical Perspective

2008 ◽  
Vol 16 (5) ◽  
pp. 340-343 ◽  
Author(s):  
Gunvant Patel
Keyword(s):  
Clinical Practice ◽  
Service Delivery ◽  
Community Treatment ◽  
Community Treatment Orders ◽  
Ethical Perspective ◽  
Human Rights Protection ◽  
Rights Protection ◽  
Optimal Service ◽  
Psychiatric Profession ◽  
The Impact

Objective: The aim of this paper is to outline the impact of Community Treatment Orders over a 20-year period on service delivery and clinical practice in Victoria. Conclusions: Community Treatment Orders, as utilized in Victoria, have undermined optimal service delivery and supported paternalistic, reductionistic clinical practice. The psychiatric profession has failed to advocate adequately for better mental health resourcing and human rights protection of those subject to Community Treatment Orders.

scholarly journals Community treatment orders: towards a new research agenda

2018 ◽  
Vol 26 (3) ◽  
pp. 299-302 ◽  
Author(s):  
Lisa Brophy ◽  
Vrinda Edan ◽  
Piers Gooding ◽  
Bernadette McSherry ◽  
Tatum Burkett ◽  
...  
Keyword(s):  
Lived Experience ◽  
Mental Health Problems ◽  
Research Priorities ◽  
Community Treatment ◽  
Future Research ◽  
Community Treatment Orders ◽  
Research Directions ◽  
Future Research Directions ◽  
Multi Stakeholder ◽  
New Research

Objectives: The aim of this study was to report on a half-day multi-stakeholder symposium on community treatment orders (CTOs) hosted by the Melbourne Social Equity Institute (MSEI), which identified research gaps and opportunities, and produced an agreed agenda for future CTO research. Methods: The MSEI convened a symposium for 22 experts in CTO research to discuss research priorities in this field in Australasia. An independent moderator elicited views and recommendations and produced a report detailing possible research projects. Results: Research on CTOs is contentious and there is a need to gather and examine information regarding both their use and utility. Due to the complexities involved, it was agreed that research should be undertaken in partnership with persons with had lived experience of mental health problems, clinicians, policymakers and other interdisciplinary stakeholders. Five key areas for future investigation were identified. Conclusions: The issues and recommendations arising from the symposium should shape the scope, nature and conduct of future research directions in the field.

A review of risk factors associated with suicide in adults with intellectual disability

2014 ◽  
Vol 8 (5) ◽  
pp. 302-308 ◽  
Author(s):  
Emma Mollison ◽  
Eddie Chaplin ◽  
Lisa Underwood ◽  
Jane McCarthy
Keyword(s):  
Mental Health ◽  
Risk Factors ◽  
At Risk ◽  
Intellectual Disability ◽  
General Population ◽  
Mental Health Problems ◽  
Health Problems ◽  
Cognitive Capacity ◽  
Content Type ◽  
Factors Associated

Purpose – Suicide is one of the top three leading causes of death amongst those aged between 15 and 44 years; and tenth leading cause of death in the wider population. The base rates of suicide, suicide attempts and suicide-related behaviours are comparably low in the general population with between 17 and 68 per cent of individuals who successfully commit suicide having made a previous attempt to take their own life. As recently as the 1980's it was still a widely held belief that individuals with intellectual disability (ID) did not have the cognitive capacity to experience mental health problems and this acted as a “buffer” against suicidal behaviour. The paper aims to discuss these issues. Design/methodology/approach – The literature review covered the time period 1993-2013 and returned 117 studies, 77 of which related to individuals with ID, 37 of which related to adults. Following screening titles and abstracts 28 articles were removed. A total of nine studies were found to be eligible for inclusion in the review. A further two studies examining suicide in adolescents (up to adulthood) with ID were also considered. From the eligible studies the following information was considered: study design, sample size, strengths, limitations and the risk factors associated with an increased risk of suicide. Findings – The suicide risk factors identified during the review were found to be in keeping with the general population and included a diagnosis of clinical depression, history of self-harm, unemployment, loneliness, unemployment, an increased need for support from others, early onset mental illness and being treatment resistive. Originality/value – Suicide in individuals with ID is a topic that has not received a great deal of attention from professionals and clinicians alike. People with ID have higher rates of mental health problems and therefore it could be argued that they are more likely to be at risk. This study aims to look at risk factors specific to people with ID for clinicians to consider in their daily practice.

scholarly journals Determinants of treatment of mental disorders in Lebanon: barriers to treatment and changing patterns of service use

2018 ◽  
Vol 28 (6) ◽  
pp. 655-661 ◽  
Author(s):  
E. G. Karam ◽  
G. E. Karam ◽  
C. Farhat ◽  
L. Itani ◽  
J. Fayyad ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Disorders ◽  
Help Seeking ◽  
Service Use ◽  
Mental Health Problems ◽  
Arab World ◽  
Health Sector ◽  
National Study ◽  
Barriers To Treatment ◽  
Seeking Help

AbstractAimsTo investigate for the first time the determinants and barriers of seeking help for mental disorders in the Arab world based on a national study: Lebanese Evaluation of the Burden of Ailments and Needs Of the Nation (L.E.B.A.N.O.N).MethodsA nationally representative (n = 2857) and multistage clustered area probability household sample of adults ≥18 years and older was assessed for lifetime and 12 months mental disorders using the Composite International Diagnostic Interview. In addition, detailed information was obtained on help- seeking behaviour and barriers to treatment.ResultsIn total, 19.7% of the Lebanese with mental disorders sought any type of treatment: 91% of those who sought treatment did so within the health sector. Severity and perceived severity of disorders predicted seeking help, the highest being for panic disorder. The greatest barrier to seek help was low perceived need for treatment (73.9%). Stigma was reported to be a factor only in 5.9% of those who thought about seeking treatment. Eighty per cent of the Lebanese reported they would not be embarrassed if friends knew they were seeking help from a professional.ConclusionsA small fraction of Lebanese seek help for their mental health problems: female gender, higher education and income are predictors of positive attitudes to help seeking. Severity and recognition of disorders, more than stigma, to get treatment seem to be the most important factors in determining help seeking. The findings underscore the importance of helping the public recognise mental health disorders.

scholarly journals Community treatment orders in the UK 5 years on: a repeat national survey of psychiatrists

2016 ◽  
Vol 40 (3) ◽  
pp. 119-123 ◽  
Author(s):  
Ritz DeRidder ◽  
Andrew Molodynski ◽  
Catherine Manning ◽  
Pearse McCusker ◽  
Jorun Rugkåsa
Keyword(s):  
Clinical Practice ◽  
Patient Care ◽  
Treatment Adherence ◽  
National Survey ◽  
Community Treatment ◽  
Clinical Implications ◽  
Clinical Factors ◽  
Previous Survey ◽  
Community Treatment Orders ◽  
The Uk

Aims and methodCommunity treatment orders (CTOs) are increasingly embedded into UK practice and their use continues to rise. However, they remain highly controversial. We surveyed psychiatrists to establish their experiences and current opinions of using CTOs and to compare findings with our previous survey conducted in 2010.ResultsThe opinions of psychiatrists in the UK have not changed since 2010 in spite of recent evidence questioning the effectiveness of CTOs. Clinical factors (the need for engagement and treatment adherence, and the achievement of adherence and improved insight) remain the most important considerations in initiating and discharging a CTO.Clinical implicationsGiven the accumulating evidence from research and clinical practice that CTOs do not improve outcomes, it is concerning that psychiatrists' opinions have not altered in response, particularly given the implications for patient care.

Sign in / Sign up

Export Citation Format

Share Document