Alison Tate

Good friends are hard to find? The social networks of people with mental illness 12 years after deinstitutionalisation

Background While community care is now well established in England, the development and maintenance of social networks of people with long-term mental illness remains a major challenge to services. Aims To investigate the size of the social networks of people with long-term mental illness and the types of social support they receive in relation to their age and accommodation. Sample Thirty-nine men and 46 women (mean age: 61 years; range: 38–88). Forty nine (60%) were 65 years or under and 32 (40%) were over 65. Methods Participants were interviewed using the Social Network Guide. Comparisons were made using generalised linear modelling. Results Social networks (median 19; range 2–85) were generally larger than those reported in previous studies. Older residents (over 65 years) had closer ties than younger residents. Congregate types of community settings were relatively devoid of social supports. Conclusion Appropriate activities and social contexts are still needed to facilitate the social networks of people with mental illness, in particular, for those aged under 65 years.

Twelve Years On: The Long‐term Outcomes and Costs of Deinstitutionalisation and Community Care for People with Learning Disabilities

This paper reports on the key findings of a study into the outcomes and costs of community care for a large cohort of people with learning disabilities, supported in 12 study sites across England, who left various long‐stay hospital 12 years ago as part of a centrally monitored and evaluated government policy initiative on deinstitutionalisation. It represents the last follow‐up of a raft of linked longitudinal evaluations, conducted at four time points over a twelve‐year period. The paper identifies the findings from the last follow‐up and interprets and presents them as summary observations and trends in relation to the findings in learning disability, briefly reviewing them in relation to wider evidence on deinstitutionalisation and community care in England.

Twelve Years on: the outcomes and costs of community care following deinstitutionalization for people with intellectual disabilities in England. 1

A relatively small number of people with intellectual disabilities appear to be at risk of offending (Murphy & Mason 1999). However, those who repeatedly break the law may attract the label of psychopathic personality disorder (PPD). A review of the literature revealed there has been little research investigating the diagnosis of PPD in people with an intellectual disability. The purpose of the present research was to develop our understanding of the disorder in people with intellectual disability. Using a structured interview, 20 consultant psychiatrists in intellectual disabilities in a region of south-east England were asked their opinions about psychopathic disorder in general and how it applies to people with an intellectual disability. In particular, they were asked about the prevalence and diagnosis of PPD in people with intellectual disabilities, difficulties associated with making the diagnosis, and how services currently managed people with an intellectual disability and a diagnosis of PPD. The findings and recommendations from this work are presented.The present paper reports on the evaluation of a UK project to provide employment support services for people with intellectual disabilities. The study involved 18 participants, and focused on individual and service outcomes. The investigation was concerned with assessing how such services contribute to the development of a supportive network in the workplace. Supported employees’ social networks were mapped in terms of structural properties (e.g. size and membership) as well as supportive behaviours (e.g. companionship and confiding). The evaluation gathered qualitative and quantitative data at two points in time: at the beginning of the placement and a year later. The data set was used to determine whether placements resulted in social integration and whether changes were moderated by individual standards of living. The implications for the planning and development of employment services for people with intellectual disabilities are examined.The present paper reports the methodology and findings of a 2-year collaborative study, led by the Tizard Centre, between the Universities of Kent and Durham, and the London School of Economics, and funded by the Department of Health. The research examined the outcomes and costs of community care for approximately 200 people with intellectual disabilities in 12 different services in England. Building on previous longitudinal evaluations at 1 (time 2) and 5 years (time 3) after discharge from a long-stay hospital, the paper reports 10-year (time 4) outcomes and costs, including different group characteristics, and their relationships with outcomes and costs. The key trends in outcomes and costs between times 1, 2, 3 and 4, and the relationships between costs and outcomes over time are also reported. Important issues for the planning and development of intellectual disability services, such as ageing, changing needs, and residential outcomes and types, are included in the analysis, along with opportunities to compare different models of community care.