John Thompson

ADON

NFMHS

TO PROVIDE A NATIONAL SERVICEFOR PEOPLE WITH A MENTAL ILLNESSWHO REQUIRE INTENSIVE PSYCHIATRIC

TREATMENT AND REHABILTATIONWITHIN A STRUCTURED, SECURE AND

THERAPEUTIC ENVIRONMENT.

Forensic; pertaining to, or connected with, or used in courts of law.Forensic Mental Health: Where psychiatry and the law meetClinical assessment and treatment of mentally disordered offendersAdvice and treatment for non-offender patients suffering from severe mental disorder in association with significant behavioural disturbance.??? Intellectual Disability and the Forensic Services????

Vision for Change (2006) proposed that a ‘ten bedded residential Unit, with a fully resourced Multi Disciplinary Team should be provided for the care of Intellectually Disabled persons who become severely disturbed in the context of the criminal justice system’. As a consequence of this recommendation, it is proposed that a dedicated Forensic Mental Health/Intellectual Disability (MHID) Unit will be included in the plans for the new National Forensic Mental Health Services, situated in Portrane, Co Dublin and due for opening circa 2020. In order to address current requirements, and to provide a seamless transition to the new service, it was agreed that an MHID Unit would open in the current service in 2014. This development constituted a major element of the NFMHS ‘2013 Service Plan Proposal’.

Shackell (quoted in Holman, 2007) states that the current prison system is set up for persons with an average IQ of 100. He notes that the mean average IQ for prisoners lies closer to 85, and lower for those with a diagnosed ID, therefore rendering people to be ‘set up for failure’. This ‘failure’ leads people to specialist services, in some jurisdictions to designated Forensic Intellectual Disability Services, in some instances to strict community based controls and in other instances to Forensic Mental Health Services

Whilst assessing the needs of offenders in their 2014 paper, New and James remark that the that the Prison Reform Trust (2007) estimate that 20 to 30% of UK prisoners have learning disabilities including a reduced ability to understand new or complex information leading to difficulties with everyday tasks.

Sondenaa et al (2009) note that offenders with ID may have characteristics similar to offenders in the general population. They tend to be young, male and have experienced social disadvantage and financial instability.

A recent Scottish Health Census by Thomson et al (2014) noted that 17% of their Forensic Patient cohort had either a singular diagnosis of ID, or a co-morbid diagnosis with mental health problems

Irish College of Psychiatrists (2007) stated that the minimum requirement for Irish services is two thirty bedded units and enhanced community engagement

Service established in nine bedded Unit A.Nurse led service at outsetPatient cohort, mainly from current body, utilising broad range of assessments, including Nursing assessments FEU?Admission criteria and Pathways establishedTraining needs identifiedNurses engaged in specific courses, aligned to service need

Ages range from 19 yrs to 64 yrsDiffering Socio Economic backgroundsCriminal typologyAssessment in serviceExternal assessment

Sensory GardenSensory RoomRelaxation GroupsIndividualised VEC opportunitiesPet therapyCooking/Art/Crafts individual or group sessionsStress and Anger ManagementPillar 4 (Offending Behaviours) workFamily Therapy

External assessmentsDeveloping and expanding internal pathwaysEstablishing links with local servicesSpecific training, ADI, ADOSTailoring services to suit individual needExpansion of services on Unit

Questions???john.thompson@hse,ie