Inpatient services for people with intellectual or developmental disabilities and mental health problems
Over the past few decades, care for people with intellectual disabilities 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 from time to time. Following the broadcast of BBC’s Panorama programme ‘Undercover care: the abuse exposed’ in May 2011, these services came under scrutiny. Describing such treatment as an outdated model of institutional care, the government published The Concordat to work with other stakeholders and meet 63 Transforming Care commitments, with one central commitment of moving into the community, anyone with an intellectual disability and challenging behaviour that does not need to be in a hospital setting. The dramatic reduction in hospital placements that was expected did not happen. It is now acknowledged that the complexity and scale of the challenge was underestimated and the scope and quality of data on inpatients with intellectual disability was poor. More recently, the NHS Chief Executive has committed to a hospital closure programme that will come into effect within an 18 month time frame. While the exact detail on how this is to be achieved is unclear, there is no doubting the political will to drive it through. It is important to ensure that well-intentioned initiatives to prevent inappropriate hospitalisation and abuse do not result in further disadvantaging an already disadvantaged population. This ebook has six chapters that cover a range of issues including the reasons why good in-patient services are needed to complement good community services, the different categories of such in-patient beds, the factors influencing referral patterns to these beds, the interface between challenging and offending behaviours, the overlap between forensic and non-forensic services and the regulatory structures for the future.
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