Going somewhere…?

Aims Challenging behaviours often results in exclusion from communities and is associated with worse outcomes for patients Intellectual Disability (ID). Due to substantial cut backs local community service provisions across Highland people ID, placements have dwindled recent trends indicate a high demand “crisis” inpatient admission PWID co-morbid mental health and/or pervasive developmental disorders. This project aims thematically analyse the Assessment Treatment Unit (IDATU) NHS over 5 year period (2018-2022). Methods All admitted discharged IDATU (2018-2022) were identified. Their case notes reviewed details on primary reason manually gleaned clerking document. Data also gathered demographics, diagnosed disorder, legal status length of admission. Results Total 18 new admissions had established ID illness, autism, & other organic conditions. The average age was 30.2 years. 81% formal. Length varied 1 814 days. Allowing some overlap, themes mainly fell into 3 categories: challenging behaviour related- Aggression, Abscond, Self-Neglect, Suicidal (50%), Decline mental/Physical health- Psychosis, Confusion, Weight Loss (16.7%) manageability- Vulnerability, Breakdown social situations (33.3%). Several identified amongst stated reasons notes. A pattern emerged whereby these different headings as shown by table here. Conclusion above three are not surprising. combination grouped “challenging” felt be “unmanageable” cited Notwithstanding dwindling resources workforce attrition within Service years, actual numbers roughly down 50% comparing analysis done 2012-2017 (34 Vs 18). Robust scrutiny/tightening criteria, along initiatives may helped mitigate against any inappropriate use beds. Given well researched risk institutionalisation, it interest us that our findings suggest services employed State reduce this already involved large proportion cases. It recommendation future development planning should focus, incentive, invest expand robust Highland.