The report sets out the different types of specialist in-patient services that are currently provided for people with learning disability, and describes the types of difficult and challenging circumstances in which such services can be an appropriate intervention for this group. These are always serious and challenging problems, where there are major risks to the person themselves and other people, so serious that compulsory treatment under the Mental Health Act is often required. As such, in-patient services can form an essential component of an overall integrated care pathway.
The report highlights the flawed approach of referring to all inpatient beds as “assessment and treatment units”, and instead describes six types of inpatient beds available for people with learning disabilities, mental, behavioural, or forensic issues, as well as a clear rationale for the appropriate use of these beds.
Much has been said about the enhancement of community services that is required to reduce the use of specialist in-patient services, and we wholeheartedly support the development of better community services, particularly for those with challenging behaviour and other major mental health needs. However, even if such improvements do deliver a reduction in the need for beds, a range of specialist in-patient services will still be required. Of course these must be of the highest quality, and fortunately there are assessment tools already in use (some developed by the College) that are very helpful in assessing quality. The universal adoption of such tools will go a long way to help prevent the abuse that happened at Winterbourne View from happening again.
One of the most important aspects of the report was that it was developed with active participation from service users and carers, as well as members of the Royal College of Psychiatrists, and clinicians and academics from multiple disciplines.
The report is rooted in a clear evidence base, including a literature review and evidence synthesis of all published treatment outcome studies from services providing inpatient care of people with intellectual disabilities, and a nationwide survey of all providers of inpatient beds for people with learning disabilities.
To read or download the report, click here.