A REGIONAL MENTAL IMPAIRMENT SERVICE

There is no consistent pattern of services in England for people with a learning disability who offend or have severe anti-social behaviours (‘mental impairment’). In one English health region, the mental impairment service comprises two residential units on hospital sites. The first of these (Unit A) operates as a medium-secure unit, assessing and treating patients referred by the courts. The second (Unit B) has a lower level of security, and provides long-term treatment for people with a mental impairment domiciled in its hospital's catchment area. Almost all the patients in the two units had mild learning disabilities, and substantial minorities had psychiatric and/or neurological disorders. A higher proportion of patients at the unit with the lowest level of security had psychiatric disorders and disturbed behaviour. This anomaly results from the lack of local mental impairment services throughout the region, which makes it difficult to discharge patients from Unit A. It is recommended that priority be given to the development of local mental impairment services rather then new medium-secure assessment units.