McKinnon Iain, Whitehouse Ellen, Harris Melissa, Ciausu Vlad, McCarthy Jane, Sheehan Rory
Secure Services, Cumbria Northumberland Tyne and Wear NHS Foundation Trust, Newcastle upon Tyne, UK; and Population Health Sciences Institute, Newcastle University, UK.
School of Psychology, Newcastle University, UK.
BJPsych Open. 2024 Aug 20;10(5):e148. doi: 10.1192/bjo.2024.734.
Specialist forensic community teams for people with intellectual disability and/or autism have been developed, but little is known about their extent and delivery.
To describe specialist forensic community teams for people with intellectual disability and/or autism across the UK.
An online survey was sent to representatives of each UK Trust/Health Board providing adult mental health and/or intellectual disability services. Questions covered the availability, structure and activities of specialist community forensic services. Quantitative data were summarised and associations between access to specialist forensic teams and care were tested with Chi-squared tests. Thematic analysis of free-text survey responses was used to understand the challenges of providing community forensic mental health services for this group.
A total of 49 out of 78 (63%) eligible Trusts/Health Boards responded, of which 25 (51%) had access to a specialist forensic community team. Teams operated either as part of a single Trust/Board ( = 13) or over a larger regional footprint ( = 12). The availability of specialist forensic community teams was associated with better access to offence-related interventions (χ = 15.1002, < 0.005) and co-production of patient care plans (χ = 7.8726, = 0.005). Respondents reported a wide variation in availability, expertise and perceived quality of community services. The availability of secure and generic in-patient beds, commissioning and legal barriers were also significant challenges in providing appropriate care.
Coverage of specialist community forensic teams is not universal. There are indications that such teams are associated with improved care processes, but further work is needed to establish longer-term outcomes and the optimal model of care.
针对智力残疾和/或自闭症患者的专业法医社区团队已经建立，但对其规模和服务提供情况了解甚少。
描述英国针对智力残疾和/或自闭症患者的专业法医社区团队。
向英国每个提供成人心理健康和/或智力残疾服务的信托机构/健康委员会的代表发送了一份在线调查问卷。问题涵盖专业社区法医服务的可用性、结构和活动。对定量数据进行了总结，并使用卡方检验来检验获得专业法医团队服务与护理之间的关联。通过对自由文本调查回复进行主题分析，以了解为该群体提供社区法医心理健康服务所面临的挑战。
78个符合条件的信托机构/健康委员会中有49个（63%）回复，其中25个（51%）能够获得专业法医社区团队的服务。这些团队要么作为单个信托机构/委员会的一部分运作（= 13），要么覆盖更大的区域范围（= 12）。专业法医社区团队的可用性与更好地获得与犯罪相关的干预措施（χ = 15.1002，< 0.005）以及共同制定患者护理计划（χ = 7.8726，= 0.005）相关。受访者报告称，社区服务的可用性、专业知识和感知质量存在很大差异。提供适当护理方面面临的重大挑战还包括安全和普通住院床位的可用性、委托安排和法律障碍。
专业社区法医团队的覆盖并不普遍。有迹象表明，此类团队与改善护理流程相关，但需要进一步开展工作以确定长期结果和最佳护理模式。
