Search results

The purpose of this study is to analyse the characteristics of all the referrals to the forensic MHIDD service over the past five years and to compare these characteristics to the cohort of service users attending the three general MHID services based in Dublin which are Service 1, Service 2 and Service 3.

This is a cross-sectional study of adults attending the three generic MHID services and the national forensic MHIDD service. The medical files of service users attending the MHID services were reviewed, and data such as age, gender, level of intellectual disability and psychiatric diagnoses were extracted and compiled into a database. The forensic MHIDD service has since its inception maintained a database of all referrals received and reviewed. The characteristics data needed were extracted from the forensic MHIDD database. All these data were then analysed using the Statistical Package for Social Sciences (SPSS).

The majority of the three MHID service users were in the moderate to profound range of intellectual disability, while the majority of the cases assessed by forensic MHIDD had normal IQ, borderline IQ and mild intellectual disability with 66.1%. The prevalence of neurodevelopmental disorder, schizophrenia and emotionally unstable personality disorder in the forensic MHIDD is comparable to the three MHID services. The prevalence of depression, bipolar affective disorder (BPAD), anxiety disorder and obsessive-compulsive disorder (OCD) is higher in the three MHID services than in the forensic MHIDD service.

The FHMIDD received referrals at a greater level of overall ability, with two-thirds of the service users having mild intellectual disability to normal IQ. The prevalence of neurodevelopmental disorder such as ASD and schizophrenia is comparable between the forensic MHIDD and the three MHID services. There is a higher prevalence of depression, BPAD, anxiety disorder and OCD in the three MHID services as compared to the forensic MHIDD service.

This paper aims to discuss the utility of eye movement desensitization and reprocessing (EMDR) therapy as a treatment for children with intellectual disabilities (ID) who have experienced trauma.

Relevant National Institute for Health and Care Excellence (NICE) guidance and literature were reviewed to provide support for the use of EMDR as a treatment for trauma in children with ID.

There is a growing body of evidence which demonstrates that EMDR therapy is successful for the treatment of trauma in adults and children. However, for children with ID, the research is limited despite those with ID being more likely than non-disabled peers to experience trauma such as abuse or neglect.

EMDR can only be facilitated by trained mental health nurses, psychiatrists, psychologists (clinical, forensic, counselling or educational) or occupational therapists or social workers with additional training. Finally, general practitioners who are experienced in psychotherapy or psychological trauma and have accreditation. Therefore, this highlights that there may be a lack of trained staff to facilitate this intervention and that those who are generally working with the client closely and long term such as learning disability nurses are not able to conduct this intervention.

This paper presents an account of NICE guidance and evidence of the efficacy of EMDR as a treatment for adults, children and those with ID.

This literature review aims to ascertain the outcomes and perspectives of community-based compassion-focused therapy (CFT) for adults with intellectual disabilities.

A comprehensive search of five databases was conducted systematically, with one additional study identified manually, yielding eight relevant studies. Methodological quality was appraised using two tools to account for heterogeneity in study designs.

Two studies conducted a CFT-derived task while six studies conducted full CFT interventions, of which two delivered group interventions. Qualitative findings were favourable towards CFT, though some quantitative outcomes were inconsistent across the literature and with qualitative results. It is concluded that CFT is perceived as valuable and appears to produce positive outcomes for adults with intellectual disabilities. However, larger, randomised control trials are required to establish CFT as an efficacious, evidence-based intervention.

This review provides insight into the outcomes and perspectives of CFT for individuals with an intellectual disability which has not been explicitly explored prior. Therefore, a holistic and specific examination of community-based CFT for individuals with intellectual disabilities is introduced to the literature.

A region’s transforming care partnership identified that autistic adults without an intellectual disability (ID) may be falling through gaps in services when presenting with a significant emotional and/or behavioural need in the absence of a mental health diagnosis. The region’s intensive support teams (ISTs) for adults with ID therefore piloted a short-term “behavioural support service” for this population. The purpose of this paper is to evaluate this pilot.

This study represents a mixed-methods service evaluation over a four year pilot period. The quantitative component examined referral rates and demographic data of accepted and declined referrals; and length of referral episodes and Health of The Nation Outcomes Scores (HoNOS) for accepted referrals. The qualitative component used thematic analysis to identify key themes relating to reasons for referral, clinical/therapeutic needs, and the models of support that most informed assessments and interventions at individual and systems levels.

The ISTs accepted 30 referrals and declined 53. Most accepted referrals were male (83%), and under 24 years old (57%). Average HoNOS scores were above the thresholds generally associated with hospital admission. Key qualitative themes were: transitional support; sexual risks/vulnerabilities; physical aggression; domestic violence; and attachment, trauma and personality difficulties. Support mostly followed psychotherapeutic modalities couched in trauma, attachment and second- and third-wave cognitive behavioural therapies. Positive Behaviour Support (PBS) did not emerge as a model of preference for service users or professionals.

This project represents one of the first of this type for autistic adults without an ID in the UK. It provides recommendations for future service development and research, with implications for Transforming Care policy and guidance.

The purpose of this study was to provide proof of concept and evaluate the project for the development of a forensic service in safeguarding adults at risk of harm who may have suffered a non-accidental injury as a result of physical abuse or neglect.

This pilot project arising from a Safeguarding Adults Review was designed using an iterative process. Opinion from all partners of the Safeguarding Adults’ Boards in two adjacent areas as well as using expert forensic advice from the Faculty of Forensic and Legal Medicine was sought.

All professionals recognised the need for a forensic service because at present decision-making around potential non-accidental injuries (NAI) may not be evidence based. The main barriers were seen as lack of knowledge and education combined with the area of work not being recognised as being needed and hence not commissioned. No similar service existed in England to aid the project being developed either academically or practically, other than reflecting what happens in children’s safeguarding.

The knowledge and skills as well as the resources developed for this project will aid safeguarding professionals to make more informed decisions when working with adults at risk of harm who have sustained a potential NAI.

This project has high originality with no other area in England offering a similar service or in the process of developing a service at present.

This paper aims to explore the extent to which principles of recovery-oriented practice are evident in the published perspectives and experiences of health professionals and service users on seclusion in adult mental health services.

A systematic review informed by PRISMA guidelines was conducted, drawing from four databases, which were searched in August 2018 and August 2022. Only original empirical studies rated as having “major” relevance were included. Data were extracted from 31 studies and qualitatively synthesised through deductive analysis using recovery principles as themes.

There was limited evidence of perceptions of seclusion being being consistent with recovery principles, with greater evidence of perceptions that directly opposed them. Studies of service user perspectives highlighted this more often than staff perspectives. The findings highlight paradoxical relationships between care and control and conflicting rights and emphasise the need to openly acknowledge the complexity of seclusion and its interface with recovery.

This review was developed in line with international best practice and the protocol was registered. Using a search string with only three components maximised sensitivity during searches and minimised the risk of relevant literature being missed. Limitations include the focus on studies where the full text was published in English.

This review makes a unique contribution, highlighting that, to the best of the authors’ knowledge, no studies to date have explicitly explored the perspectives and experiences of staff and service users on the use of seclusion in the context of recovery-oriented practice. The findings are relevant to clinical practice, policy and future research, including amending procedures and practices to partially reconcile seclusion and recovery where the seclusion is deemed necessary.

This paper aims to report a non-randomized control study undertaken to investigate prevalence and correlates of conduct disorder among male secondary education students in South-West Nigeria and to assess the impact of a problem-solving skills and attributional retraining (PSSAR) intervention with this population.

In total, 787 male students from two schools were screened for conduct disorder. All participants who met criteria for the disorder were allocated to either treatment (n = 55) or control (n = 47) groups. Outcome measures comprised the strengths and difficulties questionnaire (SDQ; teacher and student versions) and the teacher rating of students’ aggressive behaviors.

Of the sample, 13% were found to present with difficulties that met criteria for conduct disorder. The presence of these difficulties correlated with several demographic variables, including parental conflict and alcohol use. A statistically significant reduction in mean scores was observed for the treatment group in the student rating of the SDQ emotional subscale and total difficulties scores. Teacher ratings were less consistent in that conduct problems, prosocial behavior and total difficulties increased following the intervention, whereas peer problems and aggressive behavior were reported by teachers to reduce. No statistically significant change was found in the outcome measures for the control group.

In resource-constrained settings, school-based interventions are an important means through which treatment gaps in child and adolescent mental health can be addressed.

In resource-constrained settings, school-based interventions are an important means through which treatment gaps in child and adolescent mental health can be addressed. This study’s findings offer some preliminary support for the PSSAR intervention for conduct disorder in this context and indicate areas for further research.

Evidence-informed decision-making is considered best practice when choosing interventions in applied settings across health, social care and education. Developing that evidence base, however, is not straightforward. The pupose of this paper is to describe the process implemented by the Sharland Foundation Developmental Disabilities Applied Behavioural Research and Impact Network (SF-DDARIN) that systematically develops an evidence base for behaviorally based interventions.

In this case study, the progressive research steps undertaken by the SF-DDARIN to develop the evidence base for an online reading intervention, the Headsprout® Early Reading programme (HER®), which uses behavioural principles to promote learning to read, are described.

A series of discrete projects targeting gaps in the evidence base for HER^® led to funding two randomised controlled trials in England, one in education and one in health and social care.

This case study illustrates an original, creative and effective way of collaborating across academic research departments and applied settings to extend the evidence base for a chosen intervention systematically.