scholarly journals Sexual rights, mental disorder and intellectual disability: principles and law

2018 ◽  
Vol 24 (5) ◽  
pp. 334-345 ◽  
Author(s):  
Isabelle Le Gallez ◽  
Keith J. B. Rix ◽  
Kartina A. Choong ◽  
Helen Dewson
Keyword(s):  
Intellectual Disability ◽  
Mental Disorder ◽  
Well Being ◽  
Case Law ◽  
Sexual Relationships ◽  
Learning Objectives ◽  
Sexual Expression ◽  
List Type ◽  
Sexual Rights ◽  
Staff Attitudes

SUMMARYPeople with mental disorder and intellectual disability have the same rights to sexual expression as other people, albeit that in some cases a lack of capacity may require curtailment of those rights and regard must be had to protecting the vulnerable. Furthermore, the formation or maintenance of sexual relations, or the attainment of sexual fulfilment, may assist in the maintenance or restoration of mental health or well-being. This article demonstrates how the courts in England and Wales, applying statute law and judicial precedent, are largely supportive of the rights of people with mental disorder or intellectual disability to make decisions about sexual expression, sexual relationships and related matters, notwithstanding some societal and staff attitudes that act to prevent them fulfilling their sexual needs and making decisions about sexual and reproductive matters.LEARNING OBJECTIVES•Understand the underlying principles that apply to the exercise of their sexual rights by people with mental disorder or intellectual disability•Understand some of the obstacles to the exercise of sexual rights by people with mental disorder or intellectual disability•Understand the statute and case law that apply to the exercise of sexual rights by people with mental disorder or intellectual disabilityDECLARATION OF INTERESTNone.

scholarly journals Sexual rights, mental disorder and intellectual disability: practical implications for policy makers and practitioners

2018 ◽  
Vol 24 (6) ◽  
pp. 386-397 ◽  
Author(s):  
Helen Dewson ◽  
Keith J. B. Rix ◽  
Isabelle Le Gallez ◽  
Kartina A. Choong
Keyword(s):  
Decision Making ◽  
Intellectual Disability ◽  
Mental Disorder ◽  
Sexual Behaviour ◽  
Pregnancy Termination ◽  
Sexual Relationships ◽  
Physical Contact ◽  
Sexual Expression ◽  
List Type ◽  
International Human Rights Law

SUMMARYClear policies regarding sexual expression, sexual behaviour and related decision-making assist in ensuring that the rights of people with mental disorder or intellectual disability are upheld, and that staff know how to react to situations consistently and lawfully without interfering on the basis of their own moral judgements or personal beliefs. Sensitive and holistic planning of care that complies with domestic law, international human rights law and statutory guidance is necessary to complement such policies. Non-intimate physical contact, masturbation, sexual relationships, contraception, sterilisation and vasectomy, pregnancy, termination of pregnancy, sexual dysfunction, parenthood, marriage and civil partnership, divorce, prostitution, pornography, and sex aids and toys are all matters that may properly be part of care planning.LEARNING OBJECTIVES•Understand the limited legal basis for the formulation of policies and rules concerning sexual expression, sexual behaviour and related decision-making by people with mental disorder or intellectual disability•Be able to formulate policies concerning sexual matters as they relate to people with mental disorder or intellectual disability•Be able to plan care for psychiatric patients and community service users balancing their rights to sexual fulfilment with the protection of their own welfare and the protection of othersDECLARATION OF INTERESTNone.

scholarly journals Alcohol use disorders in people with intellectual disability

2018 ◽  
Vol 24 (4) ◽  
pp. 264-272 ◽  
Author(s):  
Fionnuala Williams ◽  
Christos Kouimtsidis ◽  
Alexander Baldacchino
Keyword(s):  
Intellectual Disability ◽  
Alcohol Use ◽  
Alcohol Use Disorders ◽  
Learning Objectives ◽  
List Type ◽  
Significant Issue ◽  
Successful Management ◽  
Addiction Services ◽  
Assessment And Treatment ◽  
The Individual

SUMMARYThis article initially highlights that although the prevalence of alcohol use disorders in people with intellectual disability (PWID) appears to be low, it is a significant issue. This group can be more vulnerable to the adverse effects of alcohol and it is likely that many PWID who have alcohol use disorders are not being identified. We go on to review the limited existing literature on treatment for PWID who have alcohol use disorders and the challenges in meeting the needs of this patient group. We explore how assessment and treatment of alcohol use disorders in this population can be and needs to be tailored to the needs of PWID on an individual basis. There is also discussion about the use of incapacity legislation to treat this group.LEARNING OBJECTIVES•Be aware that alcohol use disorders can be especially problematic for PWID, that such disorders can often go undetected and that adapted screening techniques may be needed to identify such problems•Understand the difficulties that this population has in accessing addiction services and that successful management of PWID who misuse alcohol is usually dependent on appropriate joint working between intellectual disability and addiction services•Be aware that PWID are not a homogeneous group, rather they vary widely in their abilities, necessitating interventions tailored to the individual, and that the use of compulsory measures to manage PWID who lack capacity regarding to their alcohol use should be done with cautionDECLARATION OF INTERESTNone.

Reforming fitness to plead and stand trial legislation in England and Wales

2019 ◽  
Vol 26 (1) ◽  
pp. 8-15
Author(s):  
Nuwan Galappathie ◽  
Angela Shaw
Keyword(s):  
Case Law ◽  
Mental Capacity ◽  
Learning Objectives ◽  
List Type ◽  
Consultation Process ◽  
England And Wales ◽  
Extensive Consultation ◽  
The Law ◽  
Practical Implications ◽  
Law Commission

SUMMARYThe legal decision on whether a defendant can fairly take part in a criminal trial in England and Wales is currently based on the leading case of R v Pritchard (1836), which despite subsequent case law updates does not embrace the concept of mental capacity or effectively identify defendants who are unable to meaningfully participate. Further to an extensive consultation process, the Law Commission published recommendations for reform in 2016, with a proposed new test of capacity to participate effectively in a trial and detailed suggestions for statutory reform of court procedures for managing defendants found unable to participate. Here we review the proposals and consider practical implications and suggestions regarding their implementation.LEARNING OBJECTIVESAfter reading this article you will be able to: •appreciate the current problems with the law on fitness to plead in England and Wales•understand the proposed test of capacity to participate effectively in a trial•understand the proposed changes to the procedures available when a defendant is found unable to participate.

scholarly journals A comparison of DSM and ICD classifications of mental disorder

2014 ◽  
Vol 20 (4) ◽  
pp. 280-285 ◽  
Author(s):  
Peter Tyrer
Keyword(s):  
Mental Disorder ◽  
Learning Objectives ◽  
List Type ◽  
Type Number ◽  
Behavioural Disorders ◽  
Major Player ◽  
The Usa ◽  
History Of ◽  
Pros And Cons ◽  
Research Classification

SummaryMost disorders in medicine are classified using the ICD (initiated in Paris in 1900). Mental and behavioural disorders are classified using the DSM (DSM-I was published in the USA in 1952), but it was not until DSM-III in 1980 that it became a major player. Its success was largely influenced by Robert Spitzer, who welded its disparate elements, and Melvyn Shabsin, who facilitated its acceptance. Spitzer pointed out that most diagnostic conditions in psychiatry were poorly defined, showed poor reliability in test-retest situations, and were temporally unstable. The consequence was that the beliefs of the psychiatrist seemed to matter much more than the characteristics of the patient when it came to classification. Since DSM-III there has been a split between those who adhere to DSM because it is a better research classification and those who adhere to ICD because it allows more clinical discretion in making diagnoses. This article discusses the pros and cons of both systems, and the major criticisms that have been levelled against them.LEARNING OBJECTIVESUnderstand the principles and reasoning behind classification in medicine and psychiatry.Be able to describe the recent history of psychiatric classification.Be able to compare DSM and ICD classifications of mental disorder.

scholarly journals Dissociative identity disorder: validity and use in the criminal justice system

2019 ◽  
Vol 25 (05) ◽  
pp. 287-293 ◽  
Author(s):  
Joel Paris
Keyword(s):  
Criminal Justice ◽  
Criminal Justice System ◽  
Justice System ◽  
Dissociative Identity Disorder ◽  
Case Law ◽  
Learning Objectives ◽  
List Type ◽  
History Of ◽  
Forensic Implications

SUMMARYThis review examines whether the diagnosis of dissociative identity disorder (DID) could be used to support a defence of ‘not guilty by reason of insanity’ (NGRI, or the insanity defence). The problem is that DID has doubtful validity and can easily be malingered. However, the diagnosis is listed in standard psychiatric manuals. If accepted as valid, DID would have problematic forensic implications.LEARNING OBJECTIVESAfter reading this article you will be able to: •understand the history of the DID diagnosis•evaluate the validity of the DID diagnosis•appreciate, from case law, use of DID in support of an insanity defence.DECLARATION OF INTERESTNone.

The interface between general and forensic psychiatry: a historical perspective

2014 ◽  
Vol 20 (5) ◽  
pp. 350-358 ◽  
Author(s):  
Harvey Gordon ◽  
Vivek Khosla
Keyword(s):  
Mental Disorder ◽  
Mentally Ill ◽  
Forensic Psychiatry ◽  
Learning Objectives ◽  
List Type ◽  
Type Number ◽  
Mentally Disordered Offenders ◽  
Mentally Disordered ◽  
The Past ◽  
The Uk

SummaryMental disorder and criminality are separate entities but some people with a mental disorder commit criminal offences and some criminals have a mental disorder. Before 1800 there was no separate category of mentally disordered offenders (referred to as criminal lunatics until 1948) in UK legislation. The provision of facilities for mentally disordered offenders in Britain and Ireland overlapped with, but was also separate from, provision for the mentally ill generally. The interface between general and forensic psychiatry is an area of tension and of collaboration. To understand how contemporary general and forensic psychiatry interact, it is useful to have an understanding of how factors have evolved overtime.Learning Objectives•Have an understanding of the evolution of general and forensic psychiatry in the UK over the past 200 years.•Comprehend the similarities and differences between general and forensic psychiatry.•Be aware of some of the roots of conflict between general and forensic psychiatry.

Sexuality, sexual expression in long-term care and the law

2021 ◽  
pp. 1-10
Author(s):  
Victor M. Aziz ◽  
Philip Slack
Keyword(s):  
Long Term Care ◽  
Family Members ◽  
Case Law ◽  
Sexual Expression ◽  
Staff Attitudes ◽  
Term Care ◽  
Factors Affecting ◽  
Legal Provisions ◽  
And Training

SUMMARY Balancing risk and safety in long-term care settings can be challenging while providing and respecting patients’/residents’ needs and rights in terms of sexual expression. We look at factors affecting the expression of sexuality, including staff attitudes and reactions, and the lack of policies governing sexuality. We review the various statute and case law, other legislative and quasi-legal provisions governing sexuality and sexual expression. Finally, we consider the need for clear policies and training for both staff and family members.

Co-occurring mental disorder and intellectual disability in a large sample of Australian prisoners

2013 ◽  
Vol 47 (10) ◽  
pp. 938-944 ◽  
Author(s):  
Shannon Dias ◽  
Robert S Ware ◽  
Stuart A Kinner ◽  
Nicholas G Lennox
Keyword(s):  
Intellectual Disability ◽  
Mental Disorder ◽  
Large Sample

scholarly journals HRM practices that support the employment and social inclusion of workers with an intellectual disability

2017 ◽  
Vol 46 (8) ◽  
pp. 1475-1492 ◽  
Author(s):  
Hannah Meacham ◽  
Jillian Cavanagh ◽  
Amie Shaw ◽  
Timothy Bartram
Keyword(s):  
Intellectual Disability ◽  
Intellectual Disabilities ◽  
Social Inclusion ◽  
Well Being ◽  
Case Study Methodology ◽  
Content Type ◽  
Hrm Practices ◽  
Employment Participation ◽  
Recruitment And Selection ◽  
Hr Managers

Purpose The purpose of this paper is to examine how HRM practices enhance and/or impede the employment, participation, and well-being of workers with intellectual disabilities in three hotels located in Australia. Design/methodology/approach The research employs a case study methodology, including interviews with three HR managers, three department managers, 17 workers with intellectual disabilities, and focus groups of 16 supervisors and 24 work colleagues. Findings The research found that the opportunities to participate in work are driven primarily by developing a social climate that enables social cohesion through the altruistic motives of managers/supervisors and reciprocal relationships. Originality/value The findings lend support for the importance of both formal and informal HR practices, such as inclusive recruitment and selection, mentoring, and training and development, as well as individualised day-to-day support provided by supervisors and colleagues, to improve the participation and well-being of workers with an intellectual disability.

scholarly journals Metabolic syndrome in psychiatry: advances in understanding and management

2014 ◽  
Vol 20 (2) ◽  
pp. 101-112 ◽  
Author(s):  
Cyrus S. H. Ho ◽  
Melvyn W. B. Zhang ◽  
Anselm Mak ◽  
Roger C. M. Ho
Keyword(s):  
Risk Factors ◽  
Metabolic Syndrome ◽  
Psychiatric Disorders ◽  
Psychiatric Patients ◽  
Learning Objectives ◽  
List Type ◽  
Type Number ◽  
Unhealthy Lifestyle ◽  
Definition Of ◽  
The Relationship

SummaryMetabolic syndrome comprises a number of cardiovascular risk factors that increase morbidity and mortality. The increase in incidence of the syndrome among psychiatric patients has been unanimously demonstrated in recent studies and it has become one of the greatest challenges in psychiatric practice. Besides the use of psychotropic drugs, factors such as genetic polymorphisms, inflammation, endocrinopathies and unhealthy lifestyle contribute to the association between metabolic syndrome and a number of psychiatric disorders. In this article, we review the current diagnostic criteria for metabolic syndrome and propose clinically useful guidelines for psychiatrists to identify and monitor patients who may have the syndrome. We also outline the relationship between metabolic syndrome and individual psychiatric disorders, and discuss advances in pharmacological treatment for the syndrome, such as metformin.LEARNING OBJECTIVES•Be familiar with the definition of metabolic syndrome and its parameters of measurement.•Appreciate how individual psychiatric disorders contribute to metabolic syndrome and vice versa.•Develop a framework for the prevention, screening and management of metabolic syndrome in psychiatric patients.

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