A novel care pathway for prisoners with intellectual disability designed through a Delphi process

Gautam Gulati; Stephen Quigley; Valerie Elizabeth Murphy; Evan Yacoub; John Bogue; Anthony Kearns; Conor O’Neill; Mary Kelly; Aideen Morrison; Gerard Griffin; Mary Blewitt; Elizabeth Fistein; David Meagher; Colum P. Dunne

doi:10.1108/IJPH-08-2017-0037

A novel care pathway for prisoners with intellectual disability designed through a Delphi process

Gautam Gulati, Stephen Quigley, Valerie Elizabeth Murphy, Evan Yacoub, John Bogue, Anthony Kearns, Conor O’Neill, Mary Kelly, Aideen Morrison, Gerard Griffin, Mary Blewitt, Elizabeth Fistein, David Meagher, Colum P. Dunne

Research output: Contribution to a Journal (Peer & Non Peer) › Article › peer-review

12 Citations (Scopus)

Abstract

Purpose: Individuals with an intellectual disability (ID) form a significant minority in the Irish prison population and worldwide prison populations. There is growing recognition that specialist services for such individuals are in need of development. The purpose of this paper is to propose a care pathway for the management of individuals with an ID who present in prison, based on expert elicitation and consensus. Design/methodology/approach: A convenience sample of professionals with a special interest in forensic intellectual disabilities was invited to participate in a Delphi exercise. In total, 12 agreed to participation and 10 subsequently completed the study (83.3 per cent). Expert views were elicited using a semi-structured questionnaire. Content analysis was completed using NVivo 11 software. A care pathway was subsequently proposed, based on the outcomes of the analysis, and circulated to participants for debate and consensus. A consensus was reached on management considerations. Findings: Ten experts across a range of disciplines with a combined experience of 187 years participated in the study. Current provision of care was seen as limited and geographically variable. The vulnerability of prisoners with ID was highlighted. The need for equivalence of care with the community through multidisciplinary input and development of specialist secure and residential placements to facilitate diversion was identified. Consensus was achieved on a proposed care pathway. Originality/value: This study proposes a care pathway for the assessment and management of prisoners with an ID and is, therefore, potentially relevant to those interested in this topic internationally who may similarly struggle with the current lack of decision-making tools for this setting. Although written from an Irish perspective, it outlines key considerations for psychiatrists in keeping with international guidance and, therefore, may be generalisable to other jurisdictions.

Original language	English
Pages (from-to)	276-286
Number of pages	11
Journal	International Journal of Prisoner Health
Volume	14
Issue number	4
DOIs	https://doi.org/10.1108/IJPH-08-2017-0037
Publication status	Published - 17 Dec 2018

Keywords

Intellectual disability
Ireland
Learning disability
Mental retardation
Prison
Prisoner

Authors (Note for portal: view the doc link for the full list of authors)

Authors
Gulati, G;Quigley, S;Murphy, VE;Yacoub, E;Bogue, J;Kearns, A;O'Neill, C;Kelly, M;Morrison, A;Griffin, G;Blewitt, M;Fistein, E;Meagher, D;Dunne, CP

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10.1108/IJPH-08-2017-0037

Cite this

Gulati, G., Quigley, S., Murphy, V. E., Yacoub, E., Bogue, J., Kearns, A., O’Neill, C., Kelly, M., Morrison, A., Griffin, G., Blewitt, M., Fistein, E., Meagher, D., & Dunne, C. P. (2018). A novel care pathway for prisoners with intellectual disability designed through a Delphi process. International Journal of Prisoner Health, 14(4), 276-286. https://doi.org/10.1108/IJPH-08-2017-0037

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title = "A novel care pathway for prisoners with intellectual disability designed through a Delphi process",

abstract = "Purpose: Individuals with an intellectual disability (ID) form a significant minority in the Irish prison population and worldwide prison populations. There is growing recognition that specialist services for such individuals are in need of development. The purpose of this paper is to propose a care pathway for the management of individuals with an ID who present in prison, based on expert elicitation and consensus. Design/methodology/approach: A convenience sample of professionals with a special interest in forensic intellectual disabilities was invited to participate in a Delphi exercise. In total, 12 agreed to participation and 10 subsequently completed the study (83.3 per cent). Expert views were elicited using a semi-structured questionnaire. Content analysis was completed using NVivo 11 software. A care pathway was subsequently proposed, based on the outcomes of the analysis, and circulated to participants for debate and consensus. A consensus was reached on management considerations. Findings: Ten experts across a range of disciplines with a combined experience of 187 years participated in the study. Current provision of care was seen as limited and geographically variable. The vulnerability of prisoners with ID was highlighted. The need for equivalence of care with the community through multidisciplinary input and development of specialist secure and residential placements to facilitate diversion was identified. Consensus was achieved on a proposed care pathway. Originality/value: This study proposes a care pathway for the assessment and management of prisoners with an ID and is, therefore, potentially relevant to those interested in this topic internationally who may similarly struggle with the current lack of decision-making tools for this setting. Although written from an Irish perspective, it outlines key considerations for psychiatrists in keeping with international guidance and, therefore, may be generalisable to other jurisdictions.",

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author = "Gautam Gulati and Stephen Quigley and Murphy, \{Valerie Elizabeth\} and Evan Yacoub and John Bogue and Anthony Kearns and Conor O{\textquoteright}Neill and Mary Kelly and Aideen Morrison and Gerard Griffin and Mary Blewitt and Elizabeth Fistein and David Meagher and Dunne, \{Colum P.\}",

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Gulati, G, Quigley, S, Murphy, VE, Yacoub, E, Bogue, J, Kearns, A, O’Neill, C, Kelly, M, Morrison, A, Griffin, G, Blewitt, M, Fistein, E, Meagher, D & Dunne, CP 2018, 'A novel care pathway for prisoners with intellectual disability designed through a Delphi process', International Journal of Prisoner Health, vol. 14, no. 4, pp. 276-286. https://doi.org/10.1108/IJPH-08-2017-0037

TY - JOUR

T1 - A novel care pathway for prisoners with intellectual disability designed through a Delphi process

AU - Gulati, Gautam

AU - Quigley, Stephen

AU - Murphy, Valerie Elizabeth

AU - Yacoub, Evan

AU - Bogue, John

AU - Kearns, Anthony

AU - O’Neill, Conor

AU - Kelly, Mary

AU - Morrison, Aideen

AU - Griffin, Gerard

AU - Blewitt, Mary

AU - Fistein, Elizabeth

AU - Meagher, David

AU - Dunne, Colum P.

PY - 2018/12/17

Y1 - 2018/12/17

N2 - Purpose: Individuals with an intellectual disability (ID) form a significant minority in the Irish prison population and worldwide prison populations. There is growing recognition that specialist services for such individuals are in need of development. The purpose of this paper is to propose a care pathway for the management of individuals with an ID who present in prison, based on expert elicitation and consensus. Design/methodology/approach: A convenience sample of professionals with a special interest in forensic intellectual disabilities was invited to participate in a Delphi exercise. In total, 12 agreed to participation and 10 subsequently completed the study (83.3 per cent). Expert views were elicited using a semi-structured questionnaire. Content analysis was completed using NVivo 11 software. A care pathway was subsequently proposed, based on the outcomes of the analysis, and circulated to participants for debate and consensus. A consensus was reached on management considerations. Findings: Ten experts across a range of disciplines with a combined experience of 187 years participated in the study. Current provision of care was seen as limited and geographically variable. The vulnerability of prisoners with ID was highlighted. The need for equivalence of care with the community through multidisciplinary input and development of specialist secure and residential placements to facilitate diversion was identified. Consensus was achieved on a proposed care pathway. Originality/value: This study proposes a care pathway for the assessment and management of prisoners with an ID and is, therefore, potentially relevant to those interested in this topic internationally who may similarly struggle with the current lack of decision-making tools for this setting. Although written from an Irish perspective, it outlines key considerations for psychiatrists in keeping with international guidance and, therefore, may be generalisable to other jurisdictions.

AB - Purpose: Individuals with an intellectual disability (ID) form a significant minority in the Irish prison population and worldwide prison populations. There is growing recognition that specialist services for such individuals are in need of development. The purpose of this paper is to propose a care pathway for the management of individuals with an ID who present in prison, based on expert elicitation and consensus. Design/methodology/approach: A convenience sample of professionals with a special interest in forensic intellectual disabilities was invited to participate in a Delphi exercise. In total, 12 agreed to participation and 10 subsequently completed the study (83.3 per cent). Expert views were elicited using a semi-structured questionnaire. Content analysis was completed using NVivo 11 software. A care pathway was subsequently proposed, based on the outcomes of the analysis, and circulated to participants for debate and consensus. A consensus was reached on management considerations. Findings: Ten experts across a range of disciplines with a combined experience of 187 years participated in the study. Current provision of care was seen as limited and geographically variable. The vulnerability of prisoners with ID was highlighted. The need for equivalence of care with the community through multidisciplinary input and development of specialist secure and residential placements to facilitate diversion was identified. Consensus was achieved on a proposed care pathway. Originality/value: This study proposes a care pathway for the assessment and management of prisoners with an ID and is, therefore, potentially relevant to those interested in this topic internationally who may similarly struggle with the current lack of decision-making tools for this setting. Although written from an Irish perspective, it outlines key considerations for psychiatrists in keeping with international guidance and, therefore, may be generalisable to other jurisdictions.

KW - Intellectual disability

KW - Ireland

KW - Learning disability

KW - Mental retardation

KW - Prison

KW - Prisoner

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U2 - 10.1108/IJPH-08-2017-0037

DO - 10.1108/IJPH-08-2017-0037

M3 - Article

SN - 1744-9200

VL - 14

SP - 276

EP - 286

JO - International Journal of Prisoner Health

JF - International Journal of Prisoner Health

IS - 4

ER -

A novel care pathway for prisoners with intellectual disability designed through a Delphi process

Abstract

Keywords

Authors (Note for portal: view the doc link for the full list of authors)

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