Intellectual disability

Liaison and diversion services were identified in the Bradley Report (Department of Health, 2009) as an important component in improving the health of people with intellectual disabilities who come into contact with the criminal justice system, and were a central theme within the recommendations of the report. In her chapter, Vanessa Shaw discusses some of the challenges and achievements of embedding the role of learning disability nurses (RNLDs) within a community liaison and diversion team. It is hoped that this discussion will make a positive contribution to the ongoing evaluation of liaison and diversion services being conducted by NHS England and to assist other RNLDs, who may undertake the role in the future, to embed the role effectively. The importance of risk assessments in deciding on the appropriate course of action for offenders is stressed within the Bradley report (Department of Health, 2009) and it is recommended that these are fully informed and include a multi-agency component. Within their chapter, Hutchinson and Dunn discuss the development of the community-based Individual Risk Mitigation Profile (IRMP) for people who have an intellectually disability and an offending background. The IRMP aims to provide an evidence-based overview of the risks a person with intellectual disability may present (both currently and historically) to themselves and others thus helping to guide services in the development of positive risk mitigation plans. Using a case study to reveal how the IRMP provides a structure to aid multi-disciplinary, defensible and proactive decision making in relation to risk, the authors demonstrate that the IRMP can be effective in ensuring that people with intellectual disabilities and offending behaviours receive the appropriate care and treatment options to meet their needs.Burns and Lampraki report on their qualitative research study which sought to explore the experiences of stress and the use of coping strategies from the perspective of people with intellectual disabilities currently residing within the forensic in-patient services of one NHS Trust in the North-West of England. Johnson and Thomson follow this, utilising a case orientated approach to bring together two separate data sets from recent qualitative research studies to present their chapter entitled: Journeys into Dialectical Behaviour Therapy (DBT): capturing the staff and service-user experience. The cases derived from two studies exploring both the staff team's and female service-user's experiences of the introduction of DBT into the intellectual disability, in-patient settings of one NHS Trust offering forensic services. It is concluded that undertaking DBT as either a service-user or staff member is a life changing experience and it is the aim of the chapter to offer an opportunity for reflection and shared empathetic responses regarding the similar journeys experienced by both the staff members and the female service-users during the introduction of DBT into the service. Furthermore, it is intended that the chapter highlights the importance of hearing the voice of the service-users and staff members to offer valuable insight and shared empathy when a new venture is undertaken. Within the final chapter, Keeley Smith offers her opinion regarding the support needs of learning disability nurses who facilitate sex offender treatment programmes. The discussion concentrates on the specific themes of training, clinical supervision and support, highlighting that whilst there is no doubt that learning disability nurses possess the skills, knowledge and abilities to facilitate sex offender treatment programmes, their support needs are complex and this has implications for clinical practice. Recommendations are discussed with regards to the provision of appropriate support packages for learning disability nurses facilitating sex offender treatment programmes and suggestions for future research are given.