Making a difference? Ten years of managing people with intellectual disability and forensic needs in the community
| Date | 14 December 2015 |
| Pages | 165-174 |
| Published date | 14 December 2015 |
| DOI | https://doi.org/10.1108/JIDOB-08-2015-0019 |
| Author | Jana de Villiers,Michael Doyle |
| Subject Matter | Health & social care,Learning & intellectual disabilities,Offending behaviour |
Making a difference? Ten years of
managing people with intellectual disability
and forensic needs in the community
Jana de Villiers and Michael Doyle
Dr Jana de Villiers is Consultant
Psychiatrist and
Dr Michael Doyle is Forensic
Psychologist, both at Fife
Forensic Learning Disability
Service, Lynebank Hospital,
Dunfermline, UK.
Abstract
Purpose –Nationally community services for patients with intellectual disability and forensic needs are
limited, and research to guide service development for this patient group with highly complex needs is
sparse. The purpose of this paper is to provide an overview of referrals to and case management by the
multi-agency Fife Forensic Learning Disability Service (FFLDS), including demographic data, treatment,
risk assessments and outcomes.
Design/methodology/approach –All referrals received between 2004 and 2014 were reviewed to identify
key demographic factors and to clarify the outcome of the referrals. Risks levels and presence of factors
related to ongoing risk management were identified. For those accepted, final outcomes were noted.
Findings –In total, 145 referrals were received by FFLDS between 1 January 2004 and 31 December 2014.
Of these 117 were accepted for ongoing case management. In total 106 patients were discharged from
FFLDS over the review period, with the vast majority remaining in community settings. Patients were
overwhelmingly male, with an age range of 16-79 (mean age of 30). Approximately half of referrals were from
criminal justice agencies, and sexual and violent offences predominated. Alcohol and/or illicit substance use
was problematic in 49 per cent of patients.
Research limitations/implications –FFLDS needs to consider building links with Drug and
Alcohol Services, for assistance in developing expertise in managing problematic alcohol and/or illicit
substance use. Links with professionals working with female offenders may increase the rate of referral
of female patients.
Originality/value –Policy and legal frameworks emphasise the need to manage people with learning
disabilities and forensic needs in the least restrictive environment possible. This paper provides information
on a cohort of forensic patients over a ten-year period, including characteristics and outcomes, to inform
the evaluation of these frameworks and the planning of both community and in-patient services for this
patient group.
Keywords Intellectual disability, Forensic, Community, Learning disability, Offending, Outcome
Paper type Research paper
Introduction
Over the past few decades the care of people with intellectual disability has shifted from being
largely within intellectual disability hospitals to largely within the community. In parallel with this
cultural change there has also been an increased focus on identifying and meeting the needs
of people with mental health and/or intellectual disabilities who come into contact with the
criminal justice system, combined with an increased societal aversion to any degree of risk
(Devapriam and Alexander, 2012). These factors have highlighted the need for a range of
services to be provided to this complex patient group.
Received 10 August 2015
Revised 18 September 2015
Accepted 15 October 2015
DOI 10.1108/JIDOB-08-2015-0019 VOL. 6 NO. 3/4 2015, pp.165-174, © Emerald Group Publishing Limited, ISSN 2050-8824
j
JOURNAL OF INTELLECTUAL DISABILITIES AND OFFENDING BEHAVIOUR
j
PAGE165
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