Hostname: page-component-cd9895bd7-8ctnn Total loading time: 0 Render date: 2024-12-31T14:29:16.605Z Has data issue: false hasContentIssue false
  • English
  • Français

One and Two Year Outcomes for Adults with Learning Disabilities Discharged to the Community

Published online by Cambridge University Press:  02 January 2018

Michael Donnelly ,
Sinead McGilloway ,
Nicholas Mays ,
Martin Knapp ,
Shane Kavanagh ,
Jennifer Beecham  and
Andrew Fenyo
Michael Donnelly*
Affiliation:
Health and Health Care Research Unit, The Queen's University of Belfast
Sinead McGilloway
Affiliation:
Health and Health Care Research Unit, The Queen's University of Belfast
Nicholas Mays
Affiliation:
Health and Health Care Research Unit, The Queen's University of Belfast
Martin Knapp
Affiliation:
Personal Social Services Research Unit, London School of Economics and Centre for the Economics of Mental Health, Institute of Psychiatry, London
Shane Kavanagh
Affiliation:
Personal Social Services Research Unit, University of Kent, Canterbury
Jennifer Beecham
Affiliation:
Personal Social Services Research Unit, University of Kent, Canterbury and Centre for the Economics of Mental Health, Institute of Psychiatry, London
Andrew Fenyo
Affiliation:
Personal Social Services Research Unit, University of Kent, Canterbury
*
Dr M. Donnelly, Health and Healthcare Research Unit, The Queen's University of Belfast, Institute of Clinical Science, Mulhouse Building, Grosvenor Road, Belfast BT12 6BJ
Get access Rights & Permissions [Opens in a new window]

Abstract

Background

Long-stay patients with learning disabilities (n=214) were assessed in hospital and 12 and 24 months after discharge in order to examine the effects of relocation.

Method

Each resident acted as his/her own control in a prospective repeated-measures design. Skills and behavioural problems were assessed by keyworkers. Self-perceived quality of life was obtained during interviews with researchers who also completed an environmental checklist of the residents' accommodation.

Results

There was little or no change in peoples low pre-discharge skill levels. Certain aspects of problem behaviour improved after 12 months, although socially unacceptable behaviour increased slightly. People were less depressed (P ⩽ 0.01) 12 months after discharge (n=119) and were more satisfied (P ⩽ 0.05) with their new ‘homes’ (n=108). There were few changes in the pattern of activities or the social networks of people 12 months later. Little or no further change in outcomes was reported 24 months after discharge.

Conclusions

The implementation of the deinstitutionalisation policy in Northern Ireland has been limited by the predominance of residential and nursing homes and the lack of ‘ordinary’ accommodation. There is a need for purchasers and providers to give more attention to ways in which the principles of normalisation could be incorporated in the process of contracting and delivering services.

Type
Papers
Information
The British Journal of Psychiatry , Volume 168 , Issue 5 , May 1996 , pp. 598 - 606
Copyright
Copyright © 1996 The Royal College of Psychiatrists 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Allen, D. (1989) The effects of deinstitutionalisation on people with mental handicaps: a review of the literature. Mental Handicap Research, 2, 18–37.Google Scholar
Beecham, J., Knapp, M., McGilloway, S., et al (1996) The cost-effectiveness of community care for adults with learning disabilities leaving long-stay hospital in Northern Ireland. Journal of Intellectual Disability Research, in press.Google Scholar
Cambridge, P., Hayes, L., Knapp, M. J. J., et al (1994) Care in the Community Five Years On. Aldershot: Ashgate.Google Scholar
Cantril, H. (1965) The Pattern of Human Concerns. New Brunswick, New Jersey: Rutgers University Press.Google Scholar
Clifford, P. (1987a) The Problems Questionnaire. London: Research and Development for Psychiatry.Google Scholar
Clifford, P. (1987b) The Social Functioning Questionnaire. London: Research and Development for Psychiatry.Google Scholar
Department of Health and Social Security (1971) Better Services for the Mentally Handicapped. London: HMSO.Google Scholar
Department of Health (1993) Services for People with Learning Disabilities and Challenging Behaviour or Mental Health Needs. London: HMSO.Google Scholar
Department of Health and Social Services (NI) (1995) A Regional Strategy for Health and Social Well-being 1997–2002. Belfast: Department of Health and Social Services.Google Scholar
Donnelly, M., McGilloway, S., Mays, N., et al (1994) Opening New Doors: An Evaluation of Community Care for People Discharged from Psychiatric and Mental Handicap Hospitals. Belfast: HMSO.Google Scholar
Eastwood, E. A. & Fisher, G. A. (1988) Skills acquisition among matched samples of institutionalised and community-based persons with mental retardation. American Journal of Mental Retardation, 93, 75–83.Google Scholar
Emerson, E., Toogood, A., Mansell, J., et al (1987) Challenging behaviour and community services: 1. Introduction and overview. Mental Handicap, 15, 166–169.Google Scholar
Emerson, E., & Hatton, C. (1994) Moving out. Relocation from Hospital to Community. London: HMSO.Google Scholar
Felce, D., De Kock, U., Saxby, H., et al (1984) Small Homes for Severely and Profoundly Mentally Handicapped Adults. University of Southampton: Health Care Evaluation Research Team.Google Scholar
Feragne, M. A., Longabaugh, R. & Stevenson, J. (1983) The psychosocial functioning inventory. Evaluation and the Health Professions, 6, 25–48.Google Scholar
Kleinberg, J. & Galligan, B. (1983) Effects of deinstitutionalisation on adaptive behaviour of mentally retarded adults. American Journal of Mental Deficiency, 88, 21–27.Google Scholar
Knapp, M. R. J., Cambridge, P., Thomason, C., et al (1992) Care in the Community: Challenge and Demonstration. Aldershot: Ashgate/Personal Social Services Research Unit.Google Scholar
Lehman, A. F. (1983) The well-being of chronic mental patients. Archives of General Psychiatry, 40, 369–373.Google Scholar
Seltzer, G. & Seltzer, M. (1983) Satisfaction questionnaire. Paper presented at the American Association of Mental Deficiency Annual Meeting on Residential Satisfaction and Community Adjustment. Cited in The First Steps (1988) (Renshaw, J., Hampson, R., Thomason, C., et al). Aldershot: Gower.Google Scholar
Snaith, A. R. P., Ahmed, S. N., Mehta, S., et al (1971) Assessment of the severity of primary depressive illness. Psychological Medicine, 1, 143–149.CrossRefGoogle ScholarPubMed
Wolfensberger, W. (1972) The Principle of Normalisation in Human Services. Toronto: National Institute on Mental Retardation.Google Scholar
Submit a response

eLetters

No eLetters have been published for this article.