Community care for people with challenging behaviours and mild learning disability: an evaluation of an assessment and treatment unit.

Abstract

This paper reports a three-year evaluation of the Mental Impairment Evaluation and Treatment Service (MIETS). MIETS, a hospital-based unit, seeks to prepare clients with a mild learning disability and challenging behaviours for resettlement in the community. The evaluation focuses on the progress of 34 clients from preadmission to six months post-discharge. The majority of clients came from hospitals or prisons, were on medication and were referred for serious challenging behaviours. For a subsample of the clients the Vineland and the Adaptive Behaviour Scale, Part II were used to assess changes in behaviour and a general trend of statistically significant decreases in maladaptive behaviour was observed. In contrast to the comprehensive assessment and treatments, behavioural observations on eight clients show that levels of participation and social engagement are not high. Twenty of the 34 clients were resettled in the community and maintained a community placement for a least six months. Some districts were unable to implement the placement recommendations; had they done so the rate of community placement would have been 80 percent. It is concluded that community care is a viable option for people with challenging behaviour; without the specialist inputs of MIETS few of the clients would have achieved community placements, but questions are raised about the length of admission.