Search results

1 – 10 of over 2000
To view the access options for this content please click here
Article
Publication date: 7 September 2012

Trine Lise Bakken, Jan Ivar Røssberg and Svein Friis

Patients who have intellectual disability and mental illness will occasionally need inpatient treatment. However, research is sparse on psychosocial factors influencing…

Abstract

Purpose

Patients who have intellectual disability and mental illness will occasionally need inpatient treatment. However, research is sparse on psychosocial factors influencing psychiatric units for patients with intellectual disabilities. The aim of this study is to examine whether adults with intellectual disabilities can reliably rate the Ward Atmosphere Scale – Real Ward (WAS‐R).

Design/methodology/approach

A total of 17 patients with mild and moderate intellectual disability and 21 staff members were asked to complete the WAS‐R. The authors used six subscales (involvement, support, practical orientation, order and organisation, angry and aggressive behaviour, and staff control) that have proved to be of major importance for patient satisfaction and treatment outcome to measure the patients' and the staff members' perceptions of the treatment milieu. To examine the internal consistency Cronbach's alpha was calculated for the patient and staff scores, respectively.

Findings

A total of 16 patients completed the form. Patients with mild intellectual disabilities were able to answer the WAS with some help, whereas patients with moderate intellectual disabilities had major difficulties with understanding more than half of the WAS items. These difficulties were also reflected in the internal consistency scores. Cronbach's alpha was satisfactory (≥0.50) for five subscales for patients with mild intellectual disabilities, but only satisfactory for two of the six subscales for patients with moderate intellectual disabilities.

Research limitations/implications

A replication study should use a shorter version of the WAS‐R, and family or caregivers should answer the WAS‐R additionally to the patients.

Originality/value

This study may encourage more research on treatment milieu for patients with intellectual disability and mental illness.

Details

Advances in Mental Health and Intellectual Disabilities, vol. 6 no. 5
Type: Research Article
ISSN: 2044-1282

Keywords

To view the access options for this content please click here
Article
Publication date: 1 November 2003

Louise Coughlin

The purpose of this research was two‐fold: first, to compare staff and patient perceptions of two new wards in a medium‐secure unit with perceptions obtained previously…

Abstract

The purpose of this research was two‐fold: first, to compare staff and patient perceptions of two new wards in a medium‐secure unit with perceptions obtained previously for a unit that has since closed, and second, to compare staff and patient perceptions of the new ward with their ideal ward environment. The results obtained from patients indicated that there were differences between perceptions of the new treatment unit and the former treatment unit. The results obtained from patients also indicated that there was a difference between perceptions of the new treatment unit and the ideal ward environment. Results obtained from staff could not be analysed because of a low response rate.

Details

The British Journal of Forensic Practice, vol. 5 no. 4
Type: Research Article
ISSN: 1463-6646

To view the access options for this content please click here
Article
Publication date: 1 December 2007

Jamie Barsky and Adrian West

This research attempts to explore in‐patient perspectives on the long‐stay, medium‐secure hospital wards in which they are based. Semi‐structured interviews focused on the…

Abstract

This research attempts to explore in‐patient perspectives on the long‐stay, medium‐secure hospital wards in which they are based. Semi‐structured interviews focused on the care provided by the hospital in comparison with the high‐secure hospitals from which the participants had been transferred. Questions focused on the participants' perceptions of recovery and the scope for it at both sites.The data suggests that participants identify increased scope for recovery at the long‐stay, medium‐secure facility, and that this is promoted by increased flexibility due to less emphasis on security. Important factors discussed by participants were increased access to a range of activities, graded access into the community, the different atmosphere in the hospital sites and the differences in potential for developing trusting relationships with staff and fellow in‐patients.

Details

The British Journal of Forensic Practice, vol. 9 no. 4
Type: Research Article
ISSN: 1463-6646

To view the access options for this content please click here
Article
Publication date: 3 March 2020

Sana Rabab, Jack Tomlin, Nick Huband and Birgit Völlm

Patients detained in high-security psychiatric hospitals are particularly vulnerable to excessive restrictions and exploitation. In the UK, the care quality commission…

Abstract

Purpose

Patients detained in high-security psychiatric hospitals are particularly vulnerable to excessive restrictions and exploitation. In the UK, the care quality commission (CQC) monitors and regulates forensic healthcare provision. The purpose of this study is to identify key concerns highlighted in CQC inspection reports of the three high-secure hospitals in England between 2010 and 2018.

Design/methodology/approach

In this qualitative study, 49 CQC inspection reports from three high-secure hospitals were subjected to thematic analysis.

Findings

Five central themes emerged: staffing and management; restrictive practice; physical environment and ward atmosphere; patients’ needs and involvement in their care; and legal and statutory matters. There was some variation in the overall quality of care between the hospitals. Positive staff–patient interactions and good practice in assessing and delivering care were consistently observed. However, enduring staff shortages within each hospital were experienced negatively and sometimes co-occurred with concerns over restrictive practices, poor care-plan procedure and inadequate legal documentation. Over time, Rampton and Broadmoor Hospitals appeared to worsen with regard to staffing levels, staff morale and management involvement. While services progressed over time in providing patients with access to advocacy and information concerning their rights, in some recent inspections it remained unclear whether patients were adequately involved in the care-plan process.

Practical implications

These findings provide preliminary indicators for areas requiring further attention from policymakers, clinicians and advocates.

Originality/value

This study appears to be the first systematic analysis of key concerns expressed in CQC reports of English high-security hospitals.

Details

The Journal of Forensic Practice, vol. 22 no. 2
Type: Research Article
ISSN: 2050-8794

Keywords

To view the access options for this content please click here
Article
Publication date: 1 September 2008

Rachel Gibson, Aleksandra Novakovic, Katie Francis, Kathryn McGilloway, Antony Adkin and Saka Odekunle

This service evaluation study aimed to demonstrate the impact of implementing ward‐based multidisciplinary therapy input on an acute psychiatric ward in a London hospital…

Abstract

This service evaluation study aimed to demonstrate the impact of implementing ward‐based multidisciplinary therapy input on an acute psychiatric ward in a London hospital for a six‐month period. The results indicated a high level of patient engagement with the project and referrals facilitated for patients following discharge. A reduction of incidents on the ward was reported over the project period compared to the previous year and there was less use of containment measures by staff by the end of the project. Recommendations are made for service improvement.

Details

Mental Health Review Journal, vol. 13 no. 3
Type: Research Article
ISSN: 1361-9322

Keywords

To view the access options for this content please click here
Article
Publication date: 4 March 2014

Laura Willets, Paul Mooney and Nicholas Blagden

The social climate of psychiatric institutions correlates with multiple outcomes related to staff and patients. Research into social climate in Learning Disability…

Abstract

Purpose

The social climate of psychiatric institutions correlates with multiple outcomes related to staff and patients. Research into social climate in Learning Disability services is limited. Staff and patients in Learning Disability services have documented both positive and negative experiences. No research has directly compared the social climate of Learning Disability and non-Learning Disability psychiatric services. The purpose of this paper is to understand how these compare. The study will also compare staff and patient views of social climate and the impact of security on social climate in Learning Disability services.

Design/methodology/approach

A total of 64 patients and 73 staff, from Learning Disability and non-Learning Disability psychiatric hospitals completed the Essen Climate Evaluation Schema (EssenCES) measure of social climate.

Findings

Patients in Learning Disability and non-Learning Disability services did not differ in their perceptions of social climate. Staff in non-Learning Disability services had a more positive perception of social climate than staff in Learning Disability services. Patients and staff did not differ in their views on climate. Security was negatively related to patients’ Experienced Safety.

Originality/value

The findings suggest that staff perceive that the deficits associated with Learning Disabilities may limit patients’ therapeutic experience and relationships with their peers. Despite this, patients with Learning Disabilities feel supported by their peers, have positive views of the treatment process and feel as safe as non-Learning Disabled psychiatric patients.

Details

Journal of Intellectual Disabilities and Offending Behaviour, vol. 5 no. 1
Type: Research Article
ISSN: 2050-8824

Keywords

To view the access options for this content please click here
Article
Publication date: 2 March 2015

Verity Chester, Julia McCathie, Marian Quinn, Lucy Ryan, Jason Popple, Camilla Loveridge and Jamie Spall

Social climate (ward atmosphere) affects numerous treatment outcomes. The most commonly used measure is the Essen Climate Evaluation Schema (EssenCES) (Schalast et al.

Abstract

Purpose

Social climate (ward atmosphere) affects numerous treatment outcomes. The most commonly used measure is the Essen Climate Evaluation Schema (EssenCES) (Schalast et al., 2008). Though studies have investigated the psychometric properties of EssenCES in intellectual disability populations, few have focused on the clinical utility, or accessibility of the measure. The purpose of this paper is to examine clinician's experiences of using this measure with this population.

Design/methodology/approach

Clinicians experienced in administering EssenCES with forensic intellectual disability patients completed an open-ended questionnaire, which sought qualitative data on their experiences of using EssenCES with this population. Data were analysed using thematic analysis.

Findings

A number of issues were raised regarding use of EssenCES with patients with intellectual disability. Four overarching themes arose: Understanding of Language, Commenting on Others, Understanding of Likert Scale, and Scale Positives and Adaptation. Clinicians felt certain items were not uniformly understood by all patients, particularly those that incorporated abstract concepts, double negatives, or complex language.

Originality/value

Results suggest forensic intellectual disability patients vary in their ability to understand EssenCES items. This resulted in significant further explanation by the administering clinician, a practice which raised concern regarding reliability. Results provide preliminary evidence to indicate EssenCES use requires further consideration in intellectual disability services, or adaptation for this client group.

Details

Advances in Mental Health and Intellectual Disabilities, vol. 9 no. 2
Type: Research Article
ISSN: 2044-1282

Keywords

To view the access options for this content please click here
Article
Publication date: 13 July 2012

Marian Quinn, Cathy Thomas and Verity Chester

The aim of the present study is to explore the psychometric properties of the EssenCES measure (patient report) of social climate in a secure service for people with…

Abstract

Purpose

The aim of the present study is to explore the psychometric properties of the EssenCES measure (patient report) of social climate in a secure service for people with intellectual disabilities.

Design/methodology/approach

Patients (37 men, 14 women, Mean age=33.24 years, SD=11.29, age range: 18‐71 years) residing in a secure intellectual disabilities service completed the EssenCES as part of routine clinical practice.

Findings

Reliability analysis revealed acceptable reliability for all three subscales (α=0.76‐0.88). In order to consider one aspect of the construct validity of this measure, a predicted group difference regarding the impact of security level on ratings of social climate was investigated. Analysis revealed that social climate ratings were more positive on low secure wards than medium secure wards as measured by the combined EssenCES subscales F(3, 31)=4.71, p=0.008; Λ=0.69; η2=0.31, and the Experienced Safety subscale, F(1, 33)=7.41, p=0.01.

Research limitations/implications

Future research should consider the link between social climate and treatment outcome within forensic secure intellectual disability services.

Originality/value

Results provide preliminary evidence to suggest that the EssenCES subscales (patient report) are reliable in this previously unconsidered population. However the validity of the measure is still unclear and requires further investigation.

Details

Advances in Mental Health and Intellectual Disabilities, vol. 6 no. 4
Type: Research Article
ISSN: 2044-1282

Keywords

To view the access options for this content please click here
Article
Publication date: 6 February 2019

Joanne Emma Robinson and Leam Craig

The purpose of this paper is to adapt a social climate measure for use within a forensic intellectual and developmental disabilities (IDD) service and examine perceptions…

Abstract

Purpose

The purpose of this paper is to adapt a social climate measure for use within a forensic intellectual and developmental disabilities (IDD) service and examine perceptions of social climate and the links with patient aggression across three levels of security.

Design/methodology/approach

Four staff participated in a focus group to discuss how the Essen Climate Evaluation Schema (EssenCES) could be adapted for IDD patients. Subsequently, a pilot study with three patients highlighted some difficulties in administering the adapted measure. Alterations in the administration of the measure were implemented with a further ten patients residing across three levels of security. The EssenCES was adapted to include more visual prompts to assist in the patients’ completion of the measure. The frequency of aggressive incidents in each of the three settings was also collated.

Findings

Statistical analysis revealed a non-significant trend where positive social climate ratings increased as the security level decreased. There was a significant difference in the frequency of aggressive incidents across the three levels of security; however, there were no significant relationships found between the questionnaire ratings and the frequency of incidents.

Research limitations/implications

The results lacked statistical power due to the low number of participants. Further studies with adapted social climate measures need to be conducted to assess the implications of social climate on individuals with IDD in secure forensic services.

Originality/value

The study adapted and piloted a social climate measure for individuals in a forensic IDD service.

Details

Journal of Intellectual Disabilities and Offending Behaviour, vol. 10 no. 1
Type: Research Article
ISSN: 2050-8824

Keywords

Content available
Article
Publication date: 7 September 2012

Steve Hardy and Jean O’Hara

Abstract

Details

Advances in Mental Health and Intellectual Disabilities, vol. 6 no. 5
Type: Research Article
ISSN: 2044-1282

1 – 10 of over 2000