Editorial

Citation

Dale, C. (2014), "Editorial", Journal of Intellectual Disabilities and Offending Behaviour, Vol. 5 No. 2. https://doi.org/10.1108/JIDOB-07-2014-0011

Editorial

Article Type: Editorial From: Journal of Intellectual Disabilities and Offending Behaviour, Volume 5, Issue 2

Pressure from the findings of the Winterbourne. View scandal and publication of MIND's (2013) findings on use of physical restraint has provoked unprecedented activity on the prevention and management of violence from Government bodies (Department of Health, 2014; HM Government, 2014; NHS England & Local Government Association, 2014; Skills for Care & Skills for Health, 2014).

It seems that the implementation of this guidance cannot come too soon. The tragic case of a health care support worker stabbed to death by a service user in a Gloucester in patient facility; and the 2014 report from the National Confidential Inquiry (NCISH, 2014) where 24 deaths were recorded within 24 hours of restraint during 2002-2013 in England and Wales (six of which occurred within one hour of restraint), underline the importance in getting things right.

The issues to be addressed are not new and have been well rehearsed over the years: staffing, attitudes, leadership, increased acuity, poor environments, lack of therapeutic activity, alcohol and substance abuse, and self-harm have all been cited as contributory factors (Duxbury et al., 2011).

My experience has told me that many organisations have poor governance around the area of preventing and managing violence in their services. At a senior level there is often ignorance of the training that is provided within their services and what alternatives might be available. A minimum requirement should be:

* performance monitoring of incidents, complaints, restraint and seclusion;

* numbers of restraint incidents and injuries received by service users and staff;

* benchmarking with other services with adjustment for populations and severity;

* senior staff undertaking training;

* seeking service user feedback;

* analysis of specific techniques; and

* trainer attendance at "approved" update training.

The Department of Health are in the process of developing the national strategy for training to support the implementation of the Positive and Proactive Care: Reducing the Need for Restrictive Interventions guidance (Department of Health, 2014). There are a number of aspects to this work including a review of the different types of positive behaviour support (PBS) training currently available, and at what level.

Based on current information they are looking at the possibility of having four levels of training:

1. basic awareness for all staff;

2. PBS skills for staff in regular contact with service users across all settings;

3. intermediate level with more enhanced knowledge and skills (certificate); and

4. experts in PBS who will supervise and mentor staff (diploma).

The strategy also proposes five work streams:

1. standards, guidance and maintaining compliance;

2. workforce training and development;

3. contracts and commissioning;

4. communication, culture and leadership; and

5. transparency, monitoring, recording and reporting.

This work will be managed and monitored through the Mental Health systems board implementing a governance arrangement with a wide range of partners.

The complexity of the task cannot be underestimated with the paucity of empirical evidence to support any proposed initiatives and a wide range of vested interests in an area where many individuals and companies have continued to practice in an unregulated area of activity. I offer them my best wishes in achieving change in an aspect of practice which is long overdue.

In this issue

Gemma Cino in her article titled, "A crime to be punished or a problem to be solved? Anti-social behaviour orders and young people with mild learning disabilities" described her literature review which critically explores the impact of Anti-Social Behaviour Orders on young people with mild learning disabilities. In an attempt to identify why young people (under the age of 18) with learning disabilities are exposed to the criminal justice system, an emerging body of evidence is considered. The research provides an insight into some of the difficulties vulnerable young people may encounter, such as receiving unrealistic prohibitions and the lack of support provided after receiving a Court Order. The research also highlights the lack of professional awareness and understanding of learning disabilities and considers the level of training available to professionals. The paper closes with a discussion of the themes identified from the literature reviewed and some of the changes proposed by the coalition government regarding the future of the criminal justice system.

Ashlee Curtis, Keith McVilly and Andrew Day from Australia look at "Sentencing offenders with mental impairment: the case of arsonists with intellectual disability". They observe that offenders with intellectual disability (ID) who commit arson and other acts of fire setting are over-represented in the criminal justice system in Australia, as in many other jurisdictions. This paper provides insight into the judicial considerations that influence sentencing in these cases.

David Kitchen, Cathy Thomas and Verity Chester consider the "Management of aggression care plans in a forensic intellectual disability service: a ten-year progress update". They explain that standardised approaches to the management of aggression and violence are critical for all stakeholders of ID services. This paper describes the management of aggression care plan. The care plan aims to reduce levels of restrictive interventions, to ensure any interventions relative to aggression and violence are the least restrictive possible, and to promote adaptive behaviours and support life enriching opportunities, in a manner which is personalised to the unique profiles of every patient.

Colleen M. Berryessa from the USA considers, "Judiciary views on criminal behaviour and intention of offenders with high-functioning autism". The purpose of this study is to explore how judges perceive High Functioning Autistic Spectrum Disorders (hfASDs) and the disorders' effects on an offender's ability to formulate criminal intent and control behaviour. Semi-structured interviews on topics related to offenders with hfASDs were conducted with 21 California Superior Court Judges.

William R. Lindsay, Kerry Joanne Smith, Samantha Tinsley, Jane Macer and Sandra Miller describe "A programme for alcohol related violence with offenders with intellectual disability". The paper explains that although studies suggest alcohol abuse is not the major problem among offenders and others with ID, it is still a significant problem. There are also suggestions that alcohol may have a more serious effect on those with ID. A programme for alcohol related problems is described and four case studies are presented to illustrate the sessions and review the way in which people with ID have responded to the methods. The cases have a mixture of alcohol related problems including anger, anxiety, social withdrawal and depression. The alcohol programme is coordinated with a range of person-centred interventions for specific difficulties.

References

Department of Health (2014), Positive and Proactive Care: Reducing the Need for Restrictive Interventions, Department of Health, London

Duxbury, J., Aiken, F. and Dale, C. (2011), "Deaths in custody: the role of restraint", Journal of Learning Disabilities and Offending Behaviour, Vol. 2 No. 4, pp. 178-89

HM Government (2014), The Mental Health Crisis Care Concordat: Improving Outcomes for People Experiencing Mental Health Crisis, TSO, London

MIND (2013), Mental Health Crisis Care: Physical Restraint in Hospital Settings in England, MIND Publications, London

NHS England & Local Government Association (2014), Ensuring quality services. Core Principles Commissioning Tool for the Development of Local Specifications for Services Supporting Children, Young People, Adults and Older People with Learning Disabilities and/or Autism who Display or are at Risk of Displaying Behaviour that Challenges, NHS England & LGA, London

Skills for Care & Skills for Health (2014), A Positive and Proactive Workforce. A Guide to Workforce Development for Commissioners and Employers Seeking to Minimise the Use of Restrictive Practices in Social Care and Health, SfH/SfC, London

Colin Dale