A comparison study of adults with intellectual disability and psychiatric disorder with and without forensic involvement.
Forensic-involved adults with ID and mental illness stay longer and move more, so budget time and beds accordingly.
01Research in Context
What this study did
Poppes et al. (2010) looked at adults with intellectual disability and mental illness inside the same Ontario psychiatric hospital.
They split the group into forensic patients (those with legal charges or court involvement) and non-forensic patients.
The team then counted how long each group stayed, how often they moved wards, and what diagnoses they carried.
What they found
Forensic patients stayed in hospital longer and changed living units more often than non-forensic peers.
Surprisingly, both groups scored the same on the Global Assessment of Functioning, meaning overall symptom severity looked alike.
The forensic group more often had mild ID and psychotic disorders, while the non-forensic group showed a wider mix.
How this fits with other research
Hardan et al. (2008) studied the same hospitals one year earlier and found that patients in specialised ID units had more challenging behaviour than those in general units.
Poppes et al. (2010) now show that forensic status, not program type, predicts longer stays, adding a new layer to the picture.
Chaplin (2004) reviewed the whole field and concluded we still can’t say if specialist or general services work better; these two Ontario studies agree that patient sub-groups differ inside either model.
Rutherford et al. (2003) saw outpatients with ID get more antipsychotics for behaviour problems; P et al. echo this by finding more psychotic diagnoses in forensic in-patients, suggesting medication patterns may follow diagnosis labels across settings.
Why it matters
If your client has a forensic history, plan for a longer admission and extra transition meetings.
Use the equal GAF scores to remind funders that symptom severity alone does not predict length of stay; legal status does.
Build discharge plans early, reserve step-down beds, and coordinate with probation or parole to cut down on costly moves.
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02At a glance
03Original abstract
The current study describes and compares profiles of patients in the same specialized hospital program for patients with intellectual disability with and without forensic involvement. A retrospective chart review of 78 individuals (39 forensic and 39 non-forensic) served between 2006 and 2008 was completed. The forensic sample was more likely to have a diagnosis of borderline to mild IQ and psychotic disorder was more common. Forensic patients were also more likely to have previously used drugs or alcohol. Forensic inpatients had significantly longer lengths of stay, and were more likely to change residence from admission to discharge than the non-forensic inpatients but the GAF scores did not differ between the two groups at admission or discharge. Although there are many similarities between the two groups, there are also some important differences that exist which should be considered in the design of inpatient and outpatient mental health and intellectual disability services.
Research in developmental disabilities, 2010 · doi:10.1016/j.ridd.2009.09.008