Out-of-area placements: Implications of psychiatric services in learning disability

Abstract

Aims and method: With an absence of appropriate residential services, people with learning disabilities are often placed outside their local areas and there is regularly no dialogue between the relevant health authorities prior to a placement being made. This survey from Leicestershire explored this issue by focusing on the catchment area covered by one consultant psychiatrist. Practice standards were formulated and compliance with these was examined. Results: A total of 29 patients were identified as 'out-of-area' placements. They had high psychiatric morbidity, exhibited significant degrees of aggression and needed a high level of professional input. The suggested practice standards were met by less than 10%. Clinical implications: In parts of the country where a large number of 'specialist' residential homes have opened, there has been an unplanned increase in the workload of local learning disability/mental health services. This can compromise patient care and there is an urgent need for health authorities to address this issue.