Working together: making the case for integrated forensic services for people with intellectual disabilities
| Date | 14 December 2015 |
| DOI | https://doi.org/10.1108/JIDOB-08-2015-0021 |
| Published date | 14 December 2015 |
| Pages | 204-210 |
| Author | Kenneth MacMahon,Ricky McClements |
| Subject Matter | Health & social care,Learning & intellectual disabilities,Offending behaviour |
Working together: making the case for
integrated forensic services for people
with intellectual disabilities
Kenneth MacMahon and Ricky McClements
Dr Kenneth MacMahon is
Senior Lecturer in Clinical
Psychology in the Department
of Clinical Psychology,
University of Edinburgh,
Edinburgh, UK.
Ricky McClements is Forensic
Nurse Practitioner in the
Learning Disability Service,
NHS Lanarkshire, Bothwell,
UK.
Abstract
Purpose –There is a general consensus that healthcare for people with intellectual disabilities should be
provided by multi-disciplinary teams. Within a forensic setting, recommendations are often made for separate
or “parallel”forensic teams, operating independently of generic mental health or intellectual disability teams.
An alternative to this model is an “integrated”service, where specialist forensic clinicians work within the
general intellectual disability service, to provide support for clients with forensic needs. For clients with
intellectual disabilities and forensic needs, there may be advantages to providing access to a wider
multi-disciplinary team, through the application of an integrated model. The purpose of this paper is to
illustrate the working of an integrated forensic service within a learning disability team, to identify positive
aspects of this model, and how potential shortcomings may be overcome.
Design/methodology/approach –Literature review, description of service outline with case example.
Findings –Although some studies have compared parallel and integrated forensic models within mental
health services, there are no evaluations that compare models of forensic services for individuals with
intellectual disabilities. However, specific advantages of an integrated model may include availability of
multi-disciplinary clinicians, development of forensic skills across wider groups of clinicians, reduction in
stigma and avoidance of delay in transfer of care between services. In addition, in areas with smaller
populations, parallel services may not be feasible due to low case numbers.
Originality/value –There has been no formal evaluation of parallel vs integrated forensic services within an
intellectual disability setting. However, the authors describe a fully integrated service and suggest means by
which the potential shortcomings of an integrated model may be overcome.
Keywords Intellectual disability, Forensic, Multi-disciplinary, Offending, Integrated, Parallel
Paper type Conceptual paper
Introduction
Over recent decades, there have been substantial developments in the provision of community
services for offenders with mental illness and those with intellectual disabilities. These followed
the closure of long-stay psychiatric hospitals and, more recently, reductions in the provision of
high-secure beds (Henderson et al., 1998). There is therefore an ever-increasing need for
responsive services, within the community, for such individuals who may present an on-going
risk of offending.
Models of service delivery
Thus, whilst there is clear agreement on the need for such community teams, there is not similar
agreement on how these services should operate. At present, there are two conceptual models
Received 17 August 2015
Revised 18 September 2015
Accepted 21 September 2015
PAGE204
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JOURNAL OF INTELLECTUAL DISABILITIES AND OFFENDING BEHAVIOUR
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VOL. 6 NO. 3/4 2015, pp.204-210, © Emerald Group Publishing Limited, ISSN 2050-8824 DOI 10.1108/JIDOB-08-2015-0021
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