A systematic review and synthesis of outcome domains for use within forensic services for people with intellectual disabilities
Catrin Morrissey,
Peter E. Langdon,
Nicole Geach,
Verity Chester,
Michael Ferriter,
William R. Lindsay,
Jane McCarthy,
John Devapriam,
Dawn-Marie Walker,
Conor Duggan,
Regi Alexander
Affiliations
Catrin Morrissey
Division of Psychiatry and Applied Psychology, School of Medicine, University of Nottingham, Nottingham, and Complex and Forensic Service, Lincolnshire Partnership NHS Foundation Trust, Lincoln, UK
Peter E. Langdon
Tizard Centre, University of Kent, Canterbury, and Broadland Clinic, Hertfordshire Partnership University NHS Foundation Trust in Norfolk, Norwich, UK
Nicole Geach
Division of Psychiatry and Applied Psychology, School of Medicine, University of Nottingham, Nottingham, UK
Verity Chester
Department of Psychiatry, Partnerships in Care, Norfolk, and Norwich Medical School, University of East Anglia, Norwich, UK
Michael Ferriter
[Retired from] Forensic Division, Nottinghamshire Healthcare NHS Trust, Nottingham, UK
William R. Lindsay
Department of Psychology, University of the West of Scotland, UK, and Department of Psychology, The Danshell Group, UK
Jane McCarthy
Department of Forensic and Neurodevelopmental Sciences (FANS), Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
John Devapriam
Department of Psychiatry, Leicestershire Partnership NHS Trust, Leicester, and Care Quality Commission, London, UK
Dawn-Marie Walker
Health Sciences, University of Southampton, Southampton, UK
Conor Duggan
Institute of Mental Health, University of Nottingham, Nottingham, UK
Regi Alexander
Department of Psychiatry, Partnerships in Care, Department of Psychiatry, Leicestershire Partnership NHS Trust, and Department of Psychiatry, University of Leicester, Leicester, UK
Background There is limited empirical information on service-level outcome domains and indicators for the large number of people with intellectual disabilities being treated in forensic psychiatric hospitals. Aims This study identified and developed the domains that should be used to measure treatment outcomes for this population. Method A systematic review of the literature highlighted 60 studies which met eligibility criteria; they were synthesised using content analysis. The findings were refined within a consultation and consensus exercises with carers, patients and experts. Results The final framework encompassed three a priori superordinate domains: (a) effectiveness, (b) patient safety and (c) patient and carer experience. Within each of these, further sub-domains emerged from our systematic review and consultation exercises. These included severity of clinical symptoms, offending behaviours, reactive and restrictive interventions, quality of life and patient satisfaction. Conclusions To index recovery, services need to measure treatment outcomes using this framework.
