The purpose of this paper is to explore the perspectives of healthcare professionals on autism in adult females with intellectual disability (ID), including regarding the gender ratio of autism, the clinical manifestation of autism in females, and the recognition, screening and diagnosis of autism.
Tromans, S., Chester, V., Kapugama, C., Elliott, A., Robertson, S., & Barrett, M.
Read researchDeliberate foreign body ingestion is a significant issue in prison and psychiatric settings. It is associated with serious physical complications, including bowel obstruction, perforation and haemorrhage. Episodes of deliberate foreign body ingestion were identified retrospectively from 5417 incident records from two inpatient forensic services (one mental health and one intellectual disability) over a one year timeframe, using related search terms. Rates were compared according to gender, diagnosis and level of security. Incidents of deliberate foreign body ingestion were found to occur on average every 2.7 days across the study population, with 133 incidents recorded over a one year period, accounted for by 27 patients. Women and patients in lower levels of security were significantly more likely to engage in deliberate foreign body ingestion. Staff responses to this behaviour were highly variable. Deliberate foreign body ingestion occurs frequently within inpatient forensic services, and can have significantly detrimental physical implications for affected patients. Further research should investigate the psychiatric and intellectual disability profile of such individuals in further detail, as well as exploring patient narratives; both of which will help inform development of treatment strategies.
Tromans, S., Chester, V., Wells, H., & Alexander, R.T.
Read researchElucidating where antisocial or violent behaviour arises within the life course of individuals with intellectual disability (ID) could improve outcomes within this population, through informing services and interventions which prevent behaviours reaching a forensic threshold. The paper aims to discuss this issue.
Chester, V., Wells, H., Lovell, M., Melvin, C., & Tromans, S.
Read researchThe Wiley Handbook on What Works for Offenders with Intellectual and Development Disabilties
Tromans, S., Chester, V. & Alexander, R.T.
Read researchResearch investigating the treatment outcomes of forensic intellectual and developmental disability (FIDD) services has largely focused on the perspectives of clinicians and researchers. This study sought the perspectives of patients and family/carers on the outcomes important to them.
Chester, V., Geach, N., & Morrissey, C.
Read researchOxford Textbook of the Psychiatry of Intellectual Disability
Lindsay, W.R., Chester, V. & Alexander, R.
Read researchOxford Textbook of the Psychiatry of Intellectual Disability
Thurston, R., Tromans, S., Chester, V., Cooper, S-A., Strydorm, A., Bhaumik, S. & Rai, D.
Read researchOxford Textbook of the Psychiatry of Intellectual Disability
Arackal, B., Chester, V., Buxton, T., Devulapally, D., & Lunsky, Y.
Read researchChester, V., James, N., Rogers, I., Grace, J., & Alexander, R.T.
Read researchRehabilitation services for people with mental illnesses have been extensively researched. However, services with similar aims and specifications for patients with intellectual disabilities (IDs) have had little focus. This study describes the characteristics and outcomes of 21 patients admitted to a specialist ID rehabilitation service over an 8-year time frame. Rather that solely accepting ‘step-down’ referrals, some patients were referred from community settings. During the study, 20 patients were discharged, 80% to lower levels of service restriction, while 14.3% to higher levels. The study suggested that rehabilitation services have an important role within the wider service model for people with ID. Within the service studied, patients were referred from both higher and lower levels of restriction, suggesting the rehabilitation service ‘bridged the gap’ between inpatient and community settings, supporting the aim of caring for patients in the least restrictive setting for their needs.
Devapriam, J., Fosker, H., Chester, V., Gangadharan, S., Hiremath, A. & Alexander, R. T.
Read researchThere are approximately 1.2 million people with an intellectual disability (ID) in the UK. They have comorbid mental health problems at a rate of about 40%, which is substantially higher than the general population. About 21% of them are in contact with specialist health services. This guidance provides some pointers for practicing clinicians in CLDTs on addressing these risks and vulnerabilities. It draws on published guidance from a range of national bodies.
Alexander, R.
Read researchThis guidance provides some pointers for practicing clinicians on addressing these risks and vulnerabilities. It draws on published guidance from a range of national bodies including Public Health England, NHS England, Royal College of Psychiatrists, Royal College of Psychiatrists – ID faculty, MENCAP, RADIANT, National Autistic Society, Autistica, Challenging Behaviour Foundation, Books beyond Words, etc.
Alexander, R.
Read researchPeople with Intellectual Disability: Guidance on Advances Planning for Treatment Escalation, Ceiling of Care, Palliative Care and End of Life
Ravi, A., Barclay, H., Mukherji, K., Chester, V. & Alexander, R.T.
Read researchAutism is difficult to identify in adults due to lack of validated self-report questionnaires. We compared the effectiveness of the autism-spectrum quotient (AQ) and the Ritvo autism-Asperger's diagnostic scale-revised (RAADS-R) questionnaires in adult mental health services in two English counties.
Brugha, T., Tyrer, F., Leaver, A., Lewis, S., Seaton, S., Morgan, Z. Tromans, S., Van Rensburg, K.
Read researchThe current COVID-19 pandemic is a pressing world crisis and people with intellectual disabilities (IDs) are vulnerable due to disparity in healthcare provision and physical and mental health multimorbidity. While most people will develop mild symptoms upon contracting severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), some will develop serious complications. The aim of this study is to present guidelines for the care and treatment of people with IDs during the COVID-19 pandemic for both community teams providing care to people with IDs and inpatient psychiatric settings. The guidelines cover specific issues associated with hospital passports, individual COVID-19 care plans, the important role of families and carers, capacity to make decisions, issues associated with social distancing, ceiling of care/treatment escalation plans, mental health and challenging behavior, and caring for someone suspected of contracting or who has contracted SARS-CoV-2 within community or inpatient psychiatric settings.
Alexander, R., Ravi, A., Barclay, H., Sawhney, I., Chester, V., Malcolm, V., Brolly, K., Mukherji, K., Zia, A., Tharian, R., Howell, A., Lane, T., Cooper, V. & Langdon, P.E.
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