The Use of Restrictive Measures in Community Services for People With Intellectual Disabilities in Sweden

ObjectivesPeople with intellectual disabilities (ID) present with behaviours that challenge community services. Community models of care as alternatives to hospital care exist but are often vary in their function. Certain strategies have been developed to manage challenging behaviour in people with ID. Data from a three-year period on a community-based service for people with ID and challenging behaviour that uses an objective, multi-disciplinary approach is presented.MethodsA case note survey of adults with ID under the care of the Assessment and Intervention Team (AIT), a challenging behaviour service in the London Borough of Haringey.ResultsOver the three-year period, 65 adults were managed by AIT. Forty-four were male and 21 were female. The age range was 21–64 years of age. The level of ID was mild ID 61%, moderate 39%. Diagnoses included psychotic disorder (25%); mood disorder (20%); developmental disorder (40%); dementia (10%); challenging behaviour (45%). Six people (11%) were admitted to hospital during their time with AIT. The length of care under AIT ranged from four to fourteen months.ConclusionsAIT managed effectively people with ID living in the community who presented with complex problems putting their placement at risk. The rate of hospital admission was reduced in this period compared with the previous three years. The length of stay in in-patient services was reduced. The most common reasons for the behaviours included mental illness and ‘challenging behaviour’. People with developmental disorders were a large proportion. Community alternatives are effective with positive benefits to the person.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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Oxford Handbook of Learning and Intellectual Disability Nursing

10.1093/med/9780198782872.001.0001 ◽

2018 ◽

Keyword(s):

Intellectual Disability ◽

Intellectual Disabilities ◽

Community Services ◽

Physical And Mental Health ◽

Republic Of Ireland ◽

Active Involvement ◽

Authoritative Text ◽

People With Intellectual Disabilities ◽

The Republic ◽

The Uk

The Oxford Handbook of Learning and Intellectual Disability Nursing, 2nd edition, has been comprehensively updated throughout and brings together the contributions of leading practitioners and academics from the UK, the Republic of Ireland, and further beyond, in an authoritative text that provides essential facts and information on nurses working with people with intellectual disabilities. A unique aspect to this Oxford Handbook is the continuing attention given to differences in legislation and social policy across the jurisdiction of the constituent countries of the UK, as well as the Republic of Ireland. The landscape for the practice of nursing has never been so complex, and given this complexity of context and practice, the Oxford Handbook of Learning and Intellectual Disability Nursing continues to offer students and newly qualified practitioners alike up-to-date and concise, practical applied knowledge, as well as theoretical information, about working in a person-centred way with people with intellectual disabilities and their families/carers in order to promote their physical and mental health, improve their quality of life and their active involvement in decisions about their care, and support their access to general healthcare and community services. This handbook will be of use in the very many areas where nurses for people with learning/intellectual disabilities are located. It will also be of use to a wider range of other health and/or social care professionals, who often seek an authoritative text that provides essential facts and information on working with people with intellectual disabilities.

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Resilience and professional quality of life in staff working with people with intellectual disabilities and offending behavior in community based and institutional settings

Health Psychology Research ◽

10.4081/hpr.2013.634 ◽

2013 ◽

Vol 1 (1) ◽

pp. 3 ◽

Cited By ~ 6

Author(s):

Erik Søndenaa ◽

Christian Lauvrud ◽

Marita Sandvik ◽

Kåre Nonstad ◽

Richard Whittington

Keyword(s):

Quality Of Life ◽

Intellectual Disabilities ◽

Local Community ◽

Community Services ◽

Institutional Setting ◽

Professional Quality Of Life ◽

Institutional Settings ◽

Professional Quality ◽

People With Intellectual Disabilities

Staff in forensic services for people with intellectual disabilities (ID) are expected to deal with a wide range of emotional challenges when providing care. The potential impact of this demanding work has not been systematically explored previously. This article explores the professional quality of life (QoL) and the resilience (hardiness) of the staff in this setting. The Professional QoL questionnaire and the Disposional Resilience Scale were completed by staff (n=85, 80% response rate) in the Norwegian forensic service for ID offenders. Responses from staff working in institutional settings were compared to those from staff in local community services. Staff in the local community services had higher resilience scores compared to the staff in the institutional setting, (t=2.19; P<0.05). However in the other QoL and resilience domains there were no differences between the staff in the two settings. The greater sense of resilient control among community staff may be a function of both the number of service users they work with and the institutional demands they face. Even though these participants worked with relatively high risk clients, they did not report significantly impaired quality of life compared to other occupations.

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The impact of transforming care on the care and safety of patients with intellectual disabilities and forensic needs

BJPsych Bulletin ◽

10.1192/pb.bp.116.055095 ◽

2017 ◽

Vol 41 (4) ◽

pp. 205-208 ◽

Cited By ~ 11

Author(s):

John L. Taylor ◽

Iain McKinnon ◽

Ian Thorpe ◽

Bruce T. Gillmer

Keyword(s):

Intellectual Disabilities ◽

Target Population ◽

Community Services ◽

Challenging Behaviour ◽

National Plan ◽

Policy And Practice ◽

Distinct Subgroup ◽

Hospital Beds ◽

People With Intellectual Disabilities ◽

The Impact

SummaryNHS England recently published a national plan to develop community services for people with intellectual disabilities and autism who display challenging behaviour by using resources from the closure of a large number of hospital beds. An ambitious timescale has been set to implement this plan. The bed closure programme is moving ahead rapidly, but there has been little progress in developing community services to support it. This paper discusses the impact of the gap between policy and practice on the care and safety of patients with intellectual disabilities and forensic needs who form a distinct subgroup of the target population and are being disproportionately affected by this government policy.

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

BJPsych Bulletin ◽

10.1192/bjb.2019.3 ◽

2019 ◽

Vol 43 (5) ◽

pp. 201-203 ◽

Cited By ~ 4

Author(s):

John L. Taylor

Keyword(s):

At Risk ◽

Intellectual Disabilities ◽

Community Services ◽

National Plan ◽

Care Programme ◽

Number Of Patients ◽

Hospital Beds ◽

People With Intellectual Disabilities ◽

Independent Sector

SummaryThe 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.

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