Pub Date : 2021-09-02DOI: 10.1108/AMHID-01-2021-0004
Jon Taylor
{"title":"Compassion in custody: developing a trauma sensitive intervention for men with developmental disabilities who have convictions for sexual offending","authors":"Jon Taylor","doi":"10.1108/AMHID-01-2021-0004","DOIUrl":"https://doi.org/10.1108/AMHID-01-2021-0004","url":null,"abstract":"","PeriodicalId":44693,"journal":{"name":"Advances in Mental Health and Intellectual Disabilities","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2021-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47757275","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-08-27DOI: 10.1108/amhid-02-2021-0006
J. Santambrogio, M. Russo, S. Terrevazzi, Gianluca Peschi, M. Clerici, M. Bertelli
Purpose Persons with intellectual disability and/or low-functioning autism spectrum didorder are with high support need (ID/ASD-HSN) are among the people who are most vulnerable to the COVID-19 pandemic. The specific vulnerability and the protective factors for persons with ID/LF-ASD attending residential and rehabilitative facilities have however received little attention. This paper aims to describe how two facilities located in the Italian COVID-19 red zone faced the risks associated with the spread of the pandemic and the results they have achieved so far. Design/methodology/approach Interventions to contrast the spread of the pandemic and preserve clients’ health conditions have been systematically monitored and recorded since the very beginning of the pandemic. Findings 26/138 clients had to undergo clinical screening and laboratory tests for COVID-like symptomatology, but only one resulted affected by COVID-19 and survived. Considering that Lombardy had 89,595 cases and 16,262 deaths (January–May 2020), one COVID-19 case/138 clients is a good result. Temporarily limiting physical contacts with friends/family in favor of reducing the burden of risk and adopting a system of prevention/safety strategies directed for persons with ID/LF-ASD attending and their caregivers have been useful measures. Research limitations/implications Structured or semi-structured interviews (using professional caregivers as informant) to confirm behavioral and emotional changes in the clients could not be carried out because of lack of time and resources (which were captured by the management of the pandemic) and could be the next goal for our residential facilities to implement the management of epidemic acute phases in a research-oriented view. Originality/value This study is a service evaluation report about facing COVID-19 pandemic. Only few such studies are present in medical literature about ID/ASD.
{"title":"Mitigating the impact of SARS-CoV-2 on residential facilities for persons with intellectual disability and/or autism spectrum disorder: two experiences from the Italian red zone","authors":"J. Santambrogio, M. Russo, S. Terrevazzi, Gianluca Peschi, M. Clerici, M. Bertelli","doi":"10.1108/amhid-02-2021-0006","DOIUrl":"https://doi.org/10.1108/amhid-02-2021-0006","url":null,"abstract":"Purpose Persons with intellectual disability and/or low-functioning autism spectrum didorder are with high support need (ID/ASD-HSN) are among the people who are most vulnerable to the COVID-19 pandemic. The specific vulnerability and the protective factors for persons with ID/LF-ASD attending residential and rehabilitative facilities have however received little attention. This paper aims to describe how two facilities located in the Italian COVID-19 red zone faced the risks associated with the spread of the pandemic and the results they have achieved so far. Design/methodology/approach Interventions to contrast the spread of the pandemic and preserve clients’ health conditions have been systematically monitored and recorded since the very beginning of the pandemic. Findings 26/138 clients had to undergo clinical screening and laboratory tests for COVID-like symptomatology, but only one resulted affected by COVID-19 and survived. Considering that Lombardy had 89,595 cases and 16,262 deaths (January–May 2020), one COVID-19 case/138 clients is a good result. Temporarily limiting physical contacts with friends/family in favor of reducing the burden of risk and adopting a system of prevention/safety strategies directed for persons with ID/LF-ASD attending and their caregivers have been useful measures. Research limitations/implications Structured or semi-structured interviews (using professional caregivers as informant) to confirm behavioral and emotional changes in the clients could not be carried out because of lack of time and resources (which were captured by the management of the pandemic) and could be the next goal for our residential facilities to implement the management of epidemic acute phases in a research-oriented view. Originality/value This study is a service evaluation report about facing COVID-19 pandemic. Only few such studies are present in medical literature about ID/ASD.","PeriodicalId":44693,"journal":{"name":"Advances in Mental Health and Intellectual Disabilities","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2021-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48862187","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-08-14DOI: 10.1108/amhid-03-2020-0006
Edward da Costa, D. Adams, Munzer Salmeh, O. Mahmoud, Ekim Yetkili
Purpose The over-reliance on psychotropic medication for the management of patients with learning disabilities with behaviour that challenges is well documented.This paper aims to discuss the application of the methodology of clinical audit within community learning disability mental health services to adapt interventions including optimising prescribing practice and behavioural interventions aiming to reduce behaviour that challenges in people with learning disabilities. Design/methodology/approach Questionnaire-based review of documentation in electronic patient records, covering relevant audit standards in line with NICE and Royal College of Psychiatrists, was carried out in the North Essex Community Learning Disability Service, Hertfordshire Partnership NHS Foundation Trust. The audit included patients on the caseload of consultant psychiatrists. Findings The audit demonstrated that the prescribing of psychotropic medication was within BNF maximum limits for all patients, evidence of “consent” procedures was being followed in the majority, and there was some evidence of deprescribing attempts.Improvement was required in several areas e.g. undocumented off label prescribing in a significant proportion of patients. Objective measures to record the severity of behaviours and the effects of the medication were being used by clinicians in only a small proportion of patients. A significant proportion of patients have prescribed medication in the absence of appropriate psychological or environmental interventions. Originality/value As a result of the audit findings, the action plan made recommendations such as the development of a database for tracking the prescribing of psychotropic medicines and routine use of standardised measures. This action has been supported by the pharmacy team. Positive developments include a clinical psychologist taking on the role of leading the development of behavioural intervention strategies.
{"title":"Using clinical audit to improve the quality of mental health-care services for people with learning disabilities","authors":"Edward da Costa, D. Adams, Munzer Salmeh, O. Mahmoud, Ekim Yetkili","doi":"10.1108/amhid-03-2020-0006","DOIUrl":"https://doi.org/10.1108/amhid-03-2020-0006","url":null,"abstract":"\u0000Purpose\u0000The over-reliance on psychotropic medication for the management of patients with learning disabilities with behaviour that challenges is well documented.This paper aims to discuss the application of the methodology of clinical audit within community learning disability mental health services to adapt interventions including optimising prescribing practice and behavioural interventions aiming to reduce behaviour that challenges in people with learning disabilities.\u0000\u0000\u0000Design/methodology/approach\u0000Questionnaire-based review of documentation in electronic patient records, covering relevant audit standards in line with NICE and Royal College of Psychiatrists, was carried out in the North Essex Community Learning Disability Service, Hertfordshire Partnership NHS Foundation Trust. The audit included patients on the caseload of consultant psychiatrists.\u0000\u0000\u0000Findings\u0000The audit demonstrated that the prescribing of psychotropic medication was within BNF maximum limits for all patients, evidence of “consent” procedures was being followed in the majority, and there was some evidence of deprescribing attempts.Improvement was required in several areas e.g. undocumented off label prescribing in a significant proportion of patients. Objective measures to record the severity of behaviours and the effects of the medication were being used by clinicians in only a small proportion of patients. A significant proportion of patients have prescribed medication in the absence of appropriate psychological or environmental interventions.\u0000\u0000\u0000Originality/value\u0000As a result of the audit findings, the action plan made recommendations such as the development of a database for tracking the prescribing of psychotropic medicines and routine use of standardised measures. This action has been supported by the pharmacy team. Positive developments include a clinical psychologist taking on the role of leading the development of behavioural intervention strategies.\u0000","PeriodicalId":44693,"journal":{"name":"Advances in Mental Health and Intellectual Disabilities","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2021-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44481424","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
PurposeThe aim of the paper is to assess whether participation in a two-session workshop led by self-advocates with mild intellectual disability (ID), supported by professional staff, affects high school students’ impression of people with ID, measured by a self-report questionnaire based on a semantic differential.Design/methodology/approachThe study was paper-pencil questionnaire-based and anonymous, conducted in Warsaw, Poland. Three measurements were performed using two semantic differentials – two weeks before the workshop, one day and three months afterward. In total, 50 high school students in the workshop group and 43 students in the control group took part in the study.FindingsAfter the workshop, people with ID were perceived as more calm, compliant and adult and this change was not observed in the control group.Research limitations/implicationsThe picture of people with ID after the workshop may probably have been even more complex than before. However, the study focuses on a specific intervention and does not include data about other, similar meetings led in another school and by other self-advocates.Practical implicationsIt is worthy to design anti-discriminatory workshops led by the self-advocates to impact the perceptions of people with ID. The particular intervention would benefit from alterations.Social implicationsWorkshops performed by self-advocates with ID may be promising in terms of limiting stereotype formation in target groups of workshops.Originality/valueThis research fills the gap in the longitudinal studies on the changes in the impressions about people with ID following an intervention based on personal contact.
目的通过基于语义差异的自我报告问卷，评估在专业人员的支持下，由轻度智障自我倡导者(self-advocates with mild intelligent disability, ID)领导的两节研讨会是否会影响高中生对轻度智障人士的印象。设计/方法/方法本研究采用纸笔问卷和匿名方式，在波兰华沙进行。使用两种语义差异进行了三次测量-研讨会前两周，一天和三个月后。总共有50名高中学生在车间组和43名学生在对照组参加了这项研究。研究结果:工作坊结束后，患有ID的人被认为更冷静、更顺从、更成熟，而在对照组中没有观察到这种变化。研究局限/启示讲习班结束后，有身份证的人的照片可能比以前更复杂。然而，这项研究关注的是一项具体的干预措施，并不包括其他在另一所学校和其他自我倡导者组织的类似会议的数据。实践启示:设计由自我倡导者领导的反歧视研讨会，以影响对身份证人士的看法是值得的。这种特殊的干预将受益于改变。社会意义由自我倡导的ID患者举办的讲习班在限制讲习班目标群体的刻板印象形成方面可能是有希望的。原创性/价值本研究填补了基于个人接触干预后对ID患者印象变化纵向研究的空白。
{"title":"Impressions about people with intellectual disability of Polish high school students who participated in a workshop led by self-advocates","authors":"Iwona Nowakowska, E. Pisuła","doi":"10.31234/osf.io/82ry4","DOIUrl":"https://doi.org/10.31234/osf.io/82ry4","url":null,"abstract":"PurposeThe aim of the paper is to assess whether participation in a two-session workshop led by self-advocates with mild intellectual disability (ID), supported by professional staff, affects high school students’ impression of people with ID, measured by a self-report questionnaire based on a semantic differential.Design/methodology/approachThe study was paper-pencil questionnaire-based and anonymous, conducted in Warsaw, Poland. Three measurements were performed using two semantic differentials – two weeks before the workshop, one day and three months afterward. In total, 50 high school students in the workshop group and 43 students in the control group took part in the study.FindingsAfter the workshop, people with ID were perceived as more calm, compliant and adult and this change was not observed in the control group.Research limitations/implicationsThe picture of people with ID after the workshop may probably have been even more complex than before. However, the study focuses on a specific intervention and does not include data about other, similar meetings led in another school and by other self-advocates.Practical implicationsIt is worthy to design anti-discriminatory workshops led by the self-advocates to impact the perceptions of people with ID. The particular intervention would benefit from alterations.Social implicationsWorkshops performed by self-advocates with ID may be promising in terms of limiting stereotype formation in target groups of workshops.Originality/valueThis research fills the gap in the longitudinal studies on the changes in the impressions about people with ID following an intervention based on personal contact.","PeriodicalId":44693,"journal":{"name":"Advances in Mental Health and Intellectual Disabilities","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2021-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43116553","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-08-04DOI: 10.1108/AMHID-03-2021-0017
J. Purrington, N. Beail
Purpose The novel coronavirus and associated mitigation efforts have produced barriers to accessing services for adults with intellectual disabilities. This paper aims to evaluate the impact of Covid-19 on access to psychological services. The paper evaluates monthly referral rates and psychological distress scores for service users awaiting therapy. Design/methodology/approach A quantitative service evaluation was completed in a psychology service based in the North of England which specialises in supporting adults with intellectual disabilities. A single case experimental design was used to examine the impact of events in March 2020 on referral rates. Descriptive statistics and effect size calculations were used to examine the impact of prolonged waiting times on psychological distress scores. Findings Referral rates were examined comparing a 5-year rolling average monthly referral rate for the 12 months prior to March 2020 with the 12 months following. Findings demonstrate that events starting in March 2020 have had a considerable impact on referral rates and rates have not recovered. Eight service users were contacted to determine the impact of prolonged waiting times with results demonstrating increases in psychological distress of large effect size. Originality/value This is the only paper the authors are aware of examining the impact of the coronavirus on access to services and psychological distress for adults with intellectual disabilities. It is hoped that these findings will be able to inform both policy and practice as services continue to navigate the pandemic.
{"title":"The impact of Covid-19 on access to psychological services","authors":"J. Purrington, N. Beail","doi":"10.1108/AMHID-03-2021-0017","DOIUrl":"https://doi.org/10.1108/AMHID-03-2021-0017","url":null,"abstract":"\u0000Purpose\u0000The novel coronavirus and associated mitigation efforts have produced barriers to accessing services for adults with intellectual disabilities. This paper aims to evaluate the impact of Covid-19 on access to psychological services. The paper evaluates monthly referral rates and psychological distress scores for service users awaiting therapy.\u0000\u0000\u0000Design/methodology/approach\u0000A quantitative service evaluation was completed in a psychology service based in the North of England which specialises in supporting adults with intellectual disabilities. A single case experimental design was used to examine the impact of events in March 2020 on referral rates. Descriptive statistics and effect size calculations were used to examine the impact of prolonged waiting times on psychological distress scores.\u0000\u0000\u0000Findings\u0000Referral rates were examined comparing a 5-year rolling average monthly referral rate for the 12 months prior to March 2020 with the 12 months following. Findings demonstrate that events starting in March 2020 have had a considerable impact on referral rates and rates have not recovered. Eight service users were contacted to determine the impact of prolonged waiting times with results demonstrating increases in psychological distress of large effect size.\u0000\u0000\u0000Originality/value\u0000This is the only paper the authors are aware of examining the impact of the coronavirus on access to services and psychological distress for adults with intellectual disabilities. It is hoped that these findings will be able to inform both policy and practice as services continue to navigate the pandemic.\u0000","PeriodicalId":44693,"journal":{"name":"Advances in Mental Health and Intellectual Disabilities","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2021-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49176739","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-07-01DOI: 10.1108/AMHID-10-2020-0024
Chloe Crompton, Bethany Duncan, G. Simpson-Adkins
Purpose This paper aims to systematically review the available evidence that explores adverse childhood experiences (ACEs) in people with intellectual disabilities (PwID). It is important to systematically review this literature as, to date, there is little known about the number of studies in this area, despite the World Health Organization declaring ACE prevention and support as a global public health priority. Design/methodology/approach Published studies were identified from electronic database searches. Key journals and reference lists were also hand searched. Findings Two studies met the inclusion criteria and the prevalence and frequency of ACEs experienced by participants of these studies analysed. Overall, due to the small number of studies meeting the inclusion criteria, it is difficult to establish any meaningful conclusions. Originality/value This appears to be the first systematic review to try and identify a research base looking at the prevalence of ACEs within a PwID population. Findings suggest that this is a highly neglected area of research, and the authors hope to have identified that further evidence is required to draw clearer conclusions about the impact of ACEs on PwID.
{"title":"A systematic review of adverse childhood experiences (ACEs) with people with intellectual disabilities: an unsafe gap in the literature","authors":"Chloe Crompton, Bethany Duncan, G. Simpson-Adkins","doi":"10.1108/AMHID-10-2020-0024","DOIUrl":"https://doi.org/10.1108/AMHID-10-2020-0024","url":null,"abstract":"\u0000Purpose\u0000This paper aims to systematically review the available evidence that explores adverse childhood experiences (ACEs) in people with intellectual disabilities (PwID). It is important to systematically review this literature as, to date, there is little known about the number of studies in this area, despite the World Health Organization declaring ACE prevention and support as a global public health priority.\u0000\u0000\u0000Design/methodology/approach\u0000Published studies were identified from electronic database searches. Key journals and reference lists were also hand searched.\u0000\u0000\u0000Findings\u0000Two studies met the inclusion criteria and the prevalence and frequency of ACEs experienced by participants of these studies analysed. Overall, due to the small number of studies meeting the inclusion criteria, it is difficult to establish any meaningful conclusions.\u0000\u0000\u0000Originality/value\u0000This appears to be the first systematic review to try and identify a research base looking at the prevalence of ACEs within a PwID population. Findings suggest that this is a highly neglected area of research, and the authors hope to have identified that further evidence is required to draw clearer conclusions about the impact of ACEs on PwID.\u0000","PeriodicalId":44693,"journal":{"name":"Advances in Mental Health and Intellectual Disabilities","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44960046","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-06-26DOI: 10.1108/AMHID-12-2020-0035
G. Rawlings, K. Wright, K. Rolling, N. Beail
Purpose Services are increasingly exploring the use of remote conferencing to deliver psychological interventions, which have become particularly important given the COVID-19 pandemic and infection control guidelines. This paper aims to explore the feasibility, acceptability and preliminary effectiveness of delivering psychological therapy remotely to adults with intellectual disabilities (ID). Design/methodology/approach As part of routine practice within an adult ID community health service, this paper develops a six-session programme based on compassion-focused therapy (CFT) and delivered it to six clients. Clients completed the psychological therapy outcome scale for ID 2nd edition, at assessment, pre- and post-therapy, as well as a feasibility and acceptability measure. Findings Six clients engaged in telephone therapy; four clients individually, while the remaining two were supported by their caregiver. Most clients found the intervention helpful, enjoyable and were pleased that they received telephone-delivered psychological therapy. A reduction was observed at post-therapy in distress (g = 0.33) and risk (g = 0.69). No difference was reported in psychological well-being. Five clients were subsequently discharged from psychological therapy. Originality/value To the knowledge, this is the first study examining the use of telephone therapy (including CFT) for individuals with ID. Findings add to the growing evidence suggesting individuals with ID can benefit from receiving adapted psychological therapies. Research is required to further explore the effectiveness of remote-therapies, who would most likely benefit from this approach and how remote treatments could be used within existing pathways.
{"title":"Telephone-delivered compassion-focused therapy for adults with intellectual disabilities: a case series","authors":"G. Rawlings, K. Wright, K. Rolling, N. Beail","doi":"10.1108/AMHID-12-2020-0035","DOIUrl":"https://doi.org/10.1108/AMHID-12-2020-0035","url":null,"abstract":"\u0000Purpose\u0000Services are increasingly exploring the use of remote conferencing to deliver psychological interventions, which have become particularly important given the COVID-19 pandemic and infection control guidelines. This paper aims to explore the feasibility, acceptability and preliminary effectiveness of delivering psychological therapy remotely to adults with intellectual disabilities (ID).\u0000\u0000\u0000Design/methodology/approach\u0000As part of routine practice within an adult ID community health service, this paper develops a six-session programme based on compassion-focused therapy (CFT) and delivered it to six clients. Clients completed the psychological therapy outcome scale for ID 2nd edition, at assessment, pre- and post-therapy, as well as a feasibility and acceptability measure.\u0000\u0000\u0000Findings\u0000Six clients engaged in telephone therapy; four clients individually, while the remaining two were supported by their caregiver. Most clients found the intervention helpful, enjoyable and were pleased that they received telephone-delivered psychological therapy. A reduction was observed at post-therapy in distress (g = 0.33) and risk (g = 0.69). No difference was reported in psychological well-being. Five clients were subsequently discharged from psychological therapy.\u0000\u0000\u0000Originality/value\u0000To the knowledge, this is the first study examining the use of telephone therapy (including CFT) for individuals with ID. Findings add to the growing evidence suggesting individuals with ID can benefit from receiving adapted psychological therapies. Research is required to further explore the effectiveness of remote-therapies, who would most likely benefit from this approach and how remote treatments could be used within existing pathways.\u0000","PeriodicalId":44693,"journal":{"name":"Advances in Mental Health and Intellectual Disabilities","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2021-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41290580","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-06-19DOI: 10.1108/amhid-11-2020-0030
Bushra Elhusein, Y. Eltorki, O. Abdallah, M. E. Tahir
Purpose Review of antipsychotic prescribing practices, rationale and follow-up using an internationally standardized audit can be an effective tool to encourage and monitor best practices. The purpose of this study is to audit the current prescribing pattern for people with intellectual disabilities and challenging behaviours in Qatar. Design/methodology/approach This study was based on the challenging behaviour management guidelines recommended by the Royal College of Psychiatrists. All current electronic medical records in the Mental Health Service-Hamad Medical Corporation were examined to identify patients with intellectual disabilities who received antipsychotics for challenging behaviour. Demographic variables, such as age, sex and nationality, were collected. In addition, details of psychiatric diagnoses, prescribed psychotropic medications and diagnoses of epilepsy were also collected. For patients who were prescribed antipsychotic medication, the clinical rationale for such medication was collected along with evidence of side effect monitoring to allow performance against the audit standards to be measured. Findings This is the first audit on prescribing practices in people with intellectual disability and challenging behaviour in the state of Qatar. The results of this study regarding the pattern of prescribing practices for patients with intellectual disability and challenging behaviour reflect the limitation in knowledge and experience among non-specialist practitioners within mental health service. The result may be helpful to support the development of specialist service provision to improve the care for such vulnerable group. The result may also help other medical centres and clinicians by providing an improved understanding of possible deviations from the best medical practices. Originality/value This is the first audit on prescribing practices in people with intellectual disability and challenging behaviour in the state of Qatar. The study is also noteworthy as, to the best of the authors’ knowledge, it is one of only a few studies on antipsychotic prescribing for patients with intellectual disability and challenging behaviour in the Middle East; therefore, it will be useful in raising awareness and promoting the best practices in the Middle East region. This study is also among the first few studies that were designed based on the four audit standards by the Royal College of Psychiatrists in this area.
{"title":"Antipsychotic prescribing for patients with intellectual disabilities and challenging behaviours","authors":"Bushra Elhusein, Y. Eltorki, O. Abdallah, M. E. Tahir","doi":"10.1108/amhid-11-2020-0030","DOIUrl":"https://doi.org/10.1108/amhid-11-2020-0030","url":null,"abstract":"\u0000Purpose\u0000Review of antipsychotic prescribing practices, rationale and follow-up using an internationally standardized audit can be an effective tool to encourage and monitor best practices. The purpose of this study is to audit the current prescribing pattern for people with intellectual disabilities and challenging behaviours in Qatar.\u0000\u0000\u0000Design/methodology/approach\u0000This study was based on the challenging behaviour management guidelines recommended by the Royal College of Psychiatrists. All current electronic medical records in the Mental Health Service-Hamad Medical Corporation were examined to identify patients with intellectual disabilities who received antipsychotics for challenging behaviour. Demographic variables, such as age, sex and nationality, were collected. In addition, details of psychiatric diagnoses, prescribed psychotropic medications and diagnoses of epilepsy were also collected. For patients who were prescribed antipsychotic medication, the clinical rationale for such medication was collected along with evidence of side effect monitoring to allow performance against the audit standards to be measured.\u0000\u0000\u0000Findings\u0000This is the first audit on prescribing practices in people with intellectual disability and challenging behaviour in the state of Qatar. The results of this study regarding the pattern of prescribing practices for patients with intellectual disability and challenging behaviour reflect the limitation in knowledge and experience among non-specialist practitioners within mental health service. The result may be helpful to support the development of specialist service provision to improve the care for such vulnerable group. The result may also help other medical centres and clinicians by providing an improved understanding of possible deviations from the best medical practices.\u0000\u0000\u0000Originality/value\u0000This is the first audit on prescribing practices in people with intellectual disability and challenging behaviour in the state of Qatar. The study is also noteworthy as, to the best of the authors’ knowledge, it is one of only a few studies on antipsychotic prescribing for patients with intellectual disability and challenging behaviour in the Middle East; therefore, it will be useful in raising awareness and promoting the best practices in the Middle East region. This study is also among the first few studies that were designed based on the four audit standards by the Royal College of Psychiatrists in this area.\u0000","PeriodicalId":44693,"journal":{"name":"Advances in Mental Health and Intellectual Disabilities","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2021-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47337586","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-06-19DOI: 10.1108/amhid-12-2020-0033
E. Rye, Joanna Anderson, M. Pickard
Purpose Many referrals to our mental health of learning disability service focus on concerns about behaviours that present risks to the referred person and to those around them, including support workers. If the referred person has good verbal ability, psychological therapy may be requested and offered, but the person may find it too difficult to engage for a number of reasons. Even when they do engage in therapy, the authors recognise the importance of helping staff better understand their attachment needs. This paper aims to demonstrate an innovative approach to helping staff provide Trauma-Informed Care (TIC). Design/methodology/approach The authors developed a training programme for support workers using psychodynamic concepts, such as splitting, transference and counter-transference, to help them develop insight into the processes that get enacted during their work. In this paper the authors have generally used the term “care staff”, recognising that an important aspect of the role of those staff is to provide care within an attachment framework; as well as support to maximise independence. Findings The feedback from staff who have attended has been very positive, both at the time and later. Staff who have attended have talked to multidisciplinary colleagues about the impact their learning has had on their ability to work with service users who present great challenges, in the context of their trauma histories. Originality/value The importance of providing TIC is gaining traction across varied settings. The authors are in the process of developing both qualitative and quantitative research programmes to evaluate this approach to increasing TIC for adults with learning disabilities, reducing staff burn out and placement breakdown.
{"title":"Developing trauma-informed care: using psychodynamic concepts to help staff respond to the attachment needs of survivors of trauma","authors":"E. Rye, Joanna Anderson, M. Pickard","doi":"10.1108/amhid-12-2020-0033","DOIUrl":"https://doi.org/10.1108/amhid-12-2020-0033","url":null,"abstract":"\u0000Purpose\u0000Many referrals to our mental health of learning disability service focus on concerns about behaviours that present risks to the referred person and to those around them, including support workers. If the referred person has good verbal ability, psychological therapy may be requested and offered, but the person may find it too difficult to engage for a number of reasons. Even when they do engage in therapy, the authors recognise the importance of helping staff better understand their attachment needs. This paper aims to demonstrate an innovative approach to helping staff provide Trauma-Informed Care (TIC).\u0000\u0000\u0000Design/methodology/approach\u0000The authors developed a training programme for support workers using psychodynamic concepts, such as splitting, transference and counter-transference, to help them develop insight into the processes that get enacted during their work. In this paper the authors have generally used the term “care staff”, recognising that an important aspect of the role of those staff is to provide care within an attachment framework; as well as support to maximise independence.\u0000\u0000\u0000Findings\u0000The feedback from staff who have attended has been very positive, both at the time and later. Staff who have attended have talked to multidisciplinary colleagues about the impact their learning has had on their ability to work with service users who present great challenges, in the context of their trauma histories.\u0000\u0000\u0000Originality/value\u0000The importance of providing TIC is gaining traction across varied settings. The authors are in the process of developing both qualitative and quantitative research programmes to evaluate this approach to increasing TIC for adults with learning disabilities, reducing staff burn out and placement breakdown.\u0000","PeriodicalId":44693,"journal":{"name":"Advances in Mental Health and Intellectual Disabilities","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2021-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49125549","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-06-19DOI: 10.1108/amhid-09-2020-0020
Jacques Bellavance, M. Diane, Catherine Mello
Purpose The behavioral phenotype of fragile X syndrome (FXS) and intellectual disability (ID) proposed by Hagerman et al. (2009) was primarily based on data from male children and teens. The purpose of this study was to promote a better understanding of how this condition manifests in adults. Design/methodology/approach A total of 18 men of FXS were paired with men with Down syndrome on the basis of age and level of ID. A screening checklist was created on the basis of existing scales and the Hagerman et al. (2009) behavioral phenotype and completed by care providers. Findings Five of the 12 features of the phenotype were significantly more present among men with FXS than in men with Down syndrome. Originality/value This study provides partial confirmation for Hagerman et al.’s (2009) behavioral phenotype of FXS among men with moderate ID and identified some traits that warrant further investigation.
{"title":"Validation of Hagerman’s behavioral phenotype for fragile X syndrome among men with intellectual disability","authors":"Jacques Bellavance, M. Diane, Catherine Mello","doi":"10.1108/amhid-09-2020-0020","DOIUrl":"https://doi.org/10.1108/amhid-09-2020-0020","url":null,"abstract":"\u0000Purpose\u0000The behavioral phenotype of fragile X syndrome (FXS) and intellectual disability (ID) proposed by Hagerman et al. (2009) was primarily based on data from male children and teens. The purpose of this study was to promote a better understanding of how this condition manifests in adults.\u0000\u0000\u0000Design/methodology/approach\u0000A total of 18 men of FXS were paired with men with Down syndrome on the basis of age and level of ID. A screening checklist was created on the basis of existing scales and the Hagerman et al. (2009) behavioral phenotype and completed by care providers.\u0000\u0000\u0000Findings\u0000Five of the 12 features of the phenotype were significantly more present among men with FXS than in men with Down syndrome.\u0000\u0000\u0000Originality/value\u0000This study provides partial confirmation for Hagerman et al.’s (2009) behavioral phenotype of FXS among men with moderate ID and identified some traits that warrant further investigation.\u0000","PeriodicalId":44693,"journal":{"name":"Advances in Mental Health and Intellectual Disabilities","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2021-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42574103","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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