Skip to main content Accessibility help
×
Home

In-patient services for people with intellectual disability and mental health or behavioural difficulties

  • John Devapriam, Alan Rosenbach and Regi Alexander

Summary

Over the past few decades, care for people with intellectual disability in the UK has moved from long-stay hospitals to the community. As in the general population, a number of these people have mental health and behavioural difficulties for which they may require in-patient services. Consequently, psychiatrists need to be aware of the in-patient mental healthcare provision for these individuals. This article describes the different categories of in-patient bed for patients with intellectual disability and ways to monitor the quality and outcomes of in-patient care.

  • View HTML
    • Send article to Kindle

      To send this article to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle.

      Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

      Find out more about the Kindle Personal Document Service.

      In-patient services for people with intellectual disability and mental health or behavioural difficulties
      Available formats
      ×

      Send article to Dropbox

      To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Dropbox.

      In-patient services for people with intellectual disability and mental health or behavioural difficulties
      Available formats
      ×

      Send article to Google Drive

      To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Google Drive.

      In-patient services for people with intellectual disability and mental health or behavioural difficulties
      Available formats
      ×

Copyright

Corresponding author

Dr John Devapriam, Leicester Frith Hospital, Mansion House, Groby Road, Leicester LE3 9QF, UK. Email: john.devapriam@leicspart.nhs.uk

Footnotes

Hide All

Learning Objectives

! Understand the need for in-patient treatment of people with intellectual disability and mental health, behavioural or forensic problems Understand the different categories of in-patient services for people with intellectual disability Understand the ways of monitoring standards and measuring outcomes for these services and people

Declaration of Interest

J.D. is the National Professional Advisor on Learning Disability to the Care Quality Commission (CQC). A.R. is the Senior Strategy Lead at the CQC and has worked on the CQC's contribution to system change for intellectual disability services. R.A. was Chair/Editor and J.D. was co-editor of the report People with Learning Disability and Mental Health, Behavioural or Forensic Problems: The Role of In-Patient Services (Royal College of Psychiatrists 2013).

Footnotes

References

Hide All
Alexander, RT, Piachaud, J, Singh, I (2001) Two districts, two models: in-patient care in the psychiatry of learning disability. British Journal of Developmental Disabilities, 47: 105–10.
Alexander, RT, Piachaud, J, Odebiyi, L et al (2002) Referrals to a forensic service in the psychiatry of learning disability. British Journal of Forensic Practice, 4: 2933.
Alexander, RT, Crouch, K, Halstead, S et al (2006) Long-term outcome from a medium secure service for people with intellectual disability. Journal of Intellectual Disability Research, 50: 305–15.
Bjelogrlic-Laakso, N, Aaltonen, S, Dorn, T et al (2014) Need for special units for the management of neuropsychiatric disorders in people with intellectual disabilities. Acta Psychiatrica Scandinavica, 130: 77–9.
Care Quality Commission (2011) Count Me In 2010: Results of the 2010 National Census of In-patients and Patients on Supervised Community Treatment in Mental Health and Learning Disability Services in England and Wales. Care Quality Commission.
Carroll, A, Lyall, M, Forrester, A (2004) Clinical hopes and public fears in forensic mental health. Journal of Forensic Psychiatry & Psychology, 15: 407–25.
Chaplin, R (2004) General psychiatric services for adults with intellectual disability and mental illness. Journal of Intellectual Disability Research, 48: 110.
Chaplin, R (2009) New research into general psychiatric services for adults with intellectual disability and mental illness. Journal of Intellectual Disability Research, 53: 189–99.
Cooper, S-A, Smiley, E, Morrison, J et al (2007) Mental ill-health in adults with intellectual disabilities: prevalence and associated factors. British Journal of Psychiatry, 190: 2735.
Cresswell, J, Bleksley, S, Lemmey, S (eds) (2010) Accreditation for In-patient Mental Health Services – Learning Disabilities (AIMS-LD): Standards for Adult In-patient Learning Disability Units – Assessment and Treatment Units (2nd edn). Royal College of Psychiatrists Centre for Quality Improvement.
Department of Health (2001) Valuing People: A New Strategy for Learning Disability for the 21st Century (White Paper). Department of Health.
Department of Health (2012a) Department of Health Review: Winterbourne View Hospital: Interim Report. Department of Health.
Department of Health (2012b) Transforming Care: A National Response to Winterbourne View Hospital: Department of Health Review Final Report. Department of Health.
Department of Health (2015) Mental Health Act 1983: Code of Practice – 2015 Revision. TSO (The Stationery Office).
Emerson, E, Baines, S (2010) Health Inequalities & People with Learning Disabilities in the UK: 2010. Learning Disability Observatory (http://www.improvinghealthandlives.org.uk/uploads/doc/vid_7479_IHaL2010–3HealthInequality2010.pdf).
Hall, I, Parkes, C, Higgins, A et al (2006a) The development of a new integrated mental health service for people with learning disabilities. British Journal of Learning Disabilities, 34: 82–7.
Hall, I, Parkes, C, Samuels, S et al (2006b) Working across boundaries: clinical outcomes for an integrated mental health service for people with intellectual disabilities. Journal of Intellectual Disability Research, 50: 598607.
Health and Social Care Information Centre (2013) Learning Disabilities Census Report – England, 30th of September 2013. HSCIC.
Holland, T, Clare, ICH, Mukhopadhyay, T (2002) Prevalence of ‘criminal offending’ by men and women with intellectual disability and the characteristics of ‘offenders’: implications for research and service development. Journal of Intellectual Disability Research, 46: 620.
Hollins, S (2000) Developmental psychiatry – insights from learning disability. British Journal of Psychiatry, 177: 201–6.
Kennedy, HG (2002) Therapeutic uses of security: mapping forensic mental health services by stratifying risk. Advances in Psychiatric Treatment, 8: 433–43.
Lindsey, M (2000) Services for people with learning disability and mental health problems. Mental Health Review, 5: 518.
Morgan, VA, Leonard, H, Bourke, J et al (2008) Intellectual disability co-occurring with schizophrenia and other psychiatric illness: population-based study. British Journal of Psychiatry, 193: 364–72.
Moss, S, Emerson, E, Bouras, N et al (2002) Mental disorders and problematic behaviours in people with intellectual disability: future directions for research. Journal of Intellectual Disability Research, 41: 440–7.
NHS Confederation (2012) Defining Mental Health Services: Promoting Effective Commissioning and Supporting QIPP. NHS Confederation.
NHS England (2013) Bed Availability and Occupancy Data – Overnight: Beds Time Series – 1987–88 to 2009–10. NHS England (http://www.england.nhs.uk/statistics/statistical-work-areas/bed-availability-and-occupancy/bed-data-overnight/).
Phillips, N (ed) (2007) Standards for People with Learning Disabilities in Medium Secure Care. London.
Plant, A, McDermott, E, Chester, V et al (2011) Substance misuse among offenders in a forensic intellectual disability service. Journal of Learning Disabilities and Offending Behaviour, 2: 127–36.
Royal College of Psychiatrists, British Psychological Society, Royal College of Speech and Language Therapists (2007) Challenging Behaviour: A Unified Approach. Clinical and Service Guidelines for Supporting People with Learning Disabilities who are at Risk of Receiving Abusive or Restrictive Practices (College Report CR144). Royal College of Psychiatrists.
Royal College of Psychiatrists (2011) Future Role of Psychiatrists Working with People with Learning Disability (Faculty Report FR/LD/1). Faculty of the Psychiatry of Learning Disability, Royal College of Psychiatrists.
Royal College of Psychiatrists (2013) People with Learning Disability and Mental Health, Behavioural or Forensic Problems: The Role of In-Patient Services (Faculty Report FR/ID/03). Faculty of Psychiatry of Intellectual Disability, Royal College of Psychiatrists.
Royal College of Psychiatrists (2014) Forensic Care Pathways for Adults with Intellectual Disability Involved with the Criminal Justice System (Faculty Report FR/ID/04). Faculty of Psychiatry of Intellectual Disability & Faculty of Forensic Psychiatry, Royal College of Psychiatrists.
Tajuddin, M, Nadkarni, S, Biswas, A et al (2004) A study of the use of an acute in-patient unit for adults with learning disability and mental health problems in Leicestershire, UK. British Journal of Developmental Disabilities, 50: 5968.
Tucker, S, Hughes, T (eds) (2007) Standards for Medium Secure Units: Quality Network for Medium Secure Units. Royal College of Psychiatrists' Centre for Quality Improvement.
Tucker, S, Iqbal, M, Holder, S (eds) (2012) Standards for Low Secure Services (CCQI publication number: CCQI 130). Royal College of Psychiatrists Centre for Quality Improvement.
World Health Organization (1992) The International Statistical Classification of Diseases and Related Health Problems, Tenth Revision (ICD-10). WHO.
Xeniditis, K, Russell, A, Murphy, D (2001) Management of people with challenging behaviour. Advances in Psychiatric Treatment, 7: 109–16.
R v Hallstrom ex parte W [1986] 2 All ER 306.

Metrics

Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed

In-patient services for people with intellectual disability and mental health or behavioural difficulties

  • John Devapriam, Alan Rosenbach and Regi Alexander
Submit a response

eLetters

No eLetters have been published for this article.

×

Reply to: Submit a response


Your details


Conflicting interests

Do you have any conflicting interests? *