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Contact the study team using the details below to take part. If there are no contact details below please ask your doctor in the first instance.
Mrs
Sarah
Lennard
cft.cider@nhs.net
Mrs
Sarah
Lennard
sarah.lennard@nhs.net
Dr
Rohit
Shankar
rohit.shankar@nhs.net
Disorders of psychological development
This information is provided directly by researchers, and we recognise that it isn't always easy to understand. We are working with researchers to improve the accessibility of this information. In some summaries, you may come across links to external websites. These websites will have more information to help you better understand the study.
Background
Since the Winterbourne View abuse scandal in 2011,NHS England announced actions to reduce psychiatric inpatient beds for people with Intellectual Disabilities (ID) with or without autism,including closing 50% of beds by 20241,2. This policy decision,while welcome in its intention to improve care of people with ID was implemented without sufficient evidence. Whilst most adults with ID live freely in the community,21% still require contact with specialist psychiatric services3. The ad hoc nature of the bed reduction has led to concerns of potential harm to vulnerable individuals with ID and complex psychiatric needs. In a recent survey of consultant psychiatrists working with people with ID (n = 65) in England,82% told of utilising specialist inpatient services,when needed,to better manage mental health and/or behavioural needs of some of their patients.4 This underlines the limited but important role of effective specialist inpatient care in the management for those with ID. There is no doubt that care and standards in specialist inpatient settings are highly variable but reducing them without consideration of improving quality of services could be catastrophic for some very vulnerable people with ID and complex psychiatric disorders5.
The current policy implies that closure of specialist beds will solve the quality problems. However,the role of specialist inpatient units particularly their effectiveness and impact,which are inexorably linked to service quality,remains poorly investigated. A recent study in London,examined all admissions and discharges to a specialist inpatient hospital facility for people with ID from 2010 to 2018 (n=169)6. All inpatients had recorded consecutive Health of the Nation Outcome Scales for people with Learning Disabilities (HoNOS-LD) scores. The HONOS -LD was chosen as it is designed and validated for use in people with an ID with mental health needs7. It measures change in an individual over two or more points in time as a measurement of outcome for therapeutic interventions7.
The London study found a 50% decrease in HoNOS-LD scores or a 15-point reduction from baseline defined as time of admission compared with end of treatment,defined as the point at which the clinical team deemed the person ready for discharge6. They found that while length of treatment was around six months,time to discharge took more than nine months. This indicated that inpatient admissions may yield a positive clinical outcome for those with ID and associated mental health,and/or behavioural co-morbidities but there remains a delay in patients being discharged from the inpatient unit after treatment completion6.
Start dates may differ between countries and research sites. The research team are responsible for keeping the information up-to-date.
The recruitment start and end dates are as follows:
Observational type: Case-controlled study;
You can take part if:
You may not be able to take part if:
Those who do not meet the inclusion criteria
Below are the locations for where you can take part in the trial. Please note that not all sites may be open.
Mrs
Sarah
Lennard
cft.cider@nhs.net
Dr
Rohit
Shankar
rohit.shankar@nhs.net
Mrs
Sarah
Lennard
sarah.lennard@nhs.net
The study is sponsored by CORNWALL PARTNERSHIP NHS FOUNDATION TRUST and funded by THE BAILY THOMAS CHARITABLE FUND .
Your feedback is important to us. It will help us improve the quality of the study information on this site. Please answer both questions.
Read full details
for Trial ID: CPMS 63809
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