Abstract

H is a 41-year-old man with mild/moderate learning disabilities and Down's syndrome. He had lived in an institution until he was 20 and has subsequently lived in a small-scale supported community setting. He was admitted to hospital under the Mental Health Act following an alleged rape of a woman with learning disabilities, and he has a long history of inappropriate behaviour, sexual and otherwise. Following the discharge an intervention package incorporating consistent support guidance, risk assessment and tailored support, cognitive behaviour therapy and counselling work, was undertaken within the context of clear behavioural boundaries, and good team work that was underpinned by a Guardianship order. H has now lived in the community for 2 years without significant incident. It is felt that external structures and limits for his behaviour will need to remain in the absence of evidence of significant change in H's attitudes and beliefs about his own behaviour and that of others.

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