Services for people with mild intellectual disabilities and challenging behaviour: Service-user views

Twenty-six people with mild intellectual disabilities and challenging behaviour, who had all been service-users at a specialist, hospital-based unit, were interviewed after they had left the service for an average of four and a half years, about their current quality of life and their memories of the service. On the whole, people were still living in the community though many had had a large number of placement moves (and some had returned to hospital or prison). The service-user's overall quality of life in their current placement was as good as that of the general population in the less restrictive environments but fell increasingly short of this standard as the placements became more restrictive. Even in the best placements people's social relationships appeared impaired when compared to the general population. With respect to their memories of the specialist service, it appeared that, despite the time period, service-users had a clear memory of the service, appreciated many aspects of it (such as the help staff provided, the therapy and education), were divided about some aspects (such as having to be in hospital, being detained under the Mental Health Act 1983, taking medication) and had very strongly negative feelings about aspects of the care which directly restricted their liberty (such as the locking of the front door, the use of restraint and seclusion). It is argued that there may be a need to re-think services for service-users with challenging behaviour and mild intellectual disabilities.