A systematic review and synthesis of outcome domains for use within forensic services for people with intellectual disabilities

Aims. In response to the large number of people with intellectual disabilities (IDs) and offending behaviour being treated in psychiatric hospitals, this study identified and developed the domains that should be used to measure treatment outcomes for this population using both a systematic review and consultation exercises.

Methods. A systematic search of relevant databases, and sixty studies met the eligibility criteria, and findings were synthesised using content analysis. The findings were refined within a consultation and consensus exercises with carers, service users, and experts.

Results. The final framework encompassed three a priori superordinate domains (a) effectiveness, (b) patient safety, and (c) patient and carer experience. Within each of these, further sub-domains emerged from our systematic review and consultation exercises. These included severity of clinical symptoms, offending behaviours, reactive and restrictive interventions, quality of life and patient satisfaction.

Conclusions. To index recovery, services need to measure outcome using this framework.