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A systematic review of in-patient psychiatric care for people with intellectual disabilities and/or autism: effectiveness, patient safety and experience

Melvin, Clare L., Barnoux, Magali F.L., Alexander, Regi, Roy, Ashok, Devapriam, John, Blair, Robert, Tromans, Samuel, Shepstone, Lee, Langdon, Peter E. (2022) A systematic review of in-patient psychiatric care for people with intellectual disabilities and/or autism: effectiveness, patient safety and experience. BJPsych Open, 8 (6). Article Number e187. ISSN 2056-4724. (doi:10.1192/bjo.2022.571) (KAR id:97607)



An increasing number of children, adolescents and adults with intellectual disabilities and/or autism are being admitted to general psychiatric wards and cared for by general psychiatrists.


The aim of this systematic review was to consider the likely effectiveness of in-patient treatment for this population, and compare and contrast differing models of in-patient care.


A systematic search was completed to identify papers where authors had reported data about the effectiveness of in-patient admissions with reference to one of three domains: treatment effect (e.g. length of stay, clinical outcome, readmission), patient safety (e.g. restrictive practices) and patient experience (e.g. patient or family satisfaction). Where possible, outcomes associated with admission were considered further within the context of differing models of in-patient care (e.g. specialist in-patient services versus general mental health in-patient services).


A total of 106 studies were included and there was evidence that improvements in mental health, social functioning, behaviour and forensic risk were associated with in-patient admission. There were two main models of in-patient psychiatric care described within the literature: admission to a specialist intellectual disability or general mental health in-patient service. Patients admitted to specialist intellectual disability in-patient services had greater complexity, but there were additional benefits, including fewer out-of-area discharges and lower seclusion rates.


There was evidence that admission to in-patient services was associated with improvements in mental health for this population. There was some evidence indicating better outcomes for those admitted to specialist services.

Item Type: Article
DOI/Identification number: 10.1192/bjo.2022.571
Uncontrolled keywords: intellectual disability; neurodevelopmental disorders; autism spectrum disorders; psychiatric in-patient treatment; mental health; hospital
Subjects: B Philosophy. Psychology. Religion > BF Psychology
R Medicine > RA Public aspects of medicine > RA790 Mental health
Divisions: Divisions > Division for the Study of Law, Society and Social Justice > School of Social Policy, Sociology and Social Research > Tizard
Funders: University of Kent (
Depositing User: Magali Barnoux
Date Deposited: 26 Oct 2022 12:03 UTC
Last Modified: 10 Dec 2022 10:04 UTC
Resource URI: (The current URI for this page, for reference purposes)

University of Kent Author Information

Barnoux, Magali F.L..

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