The purpose of this article is to raise awareness of the issue of post-traumatic stress disorder among people with learning disabilities. The article summarizes literature reviewed from MEDLINE for the period between 1997 and 2001. People with learning disabilities may experience emotional traumas that impact upon their ability to enjoy life and maintain valued relationships, with much of this trauma manifesting itself through challenging behaviour. The authors discuss key points from the literature and suggest that post-traumatic stress syndrome in people with learning disabilities frequently goes unrecognized.

It is essential that people with a learning disability and mental disorder receive the appropriate medicines in order to promote both their physical and mental health. However, medication administration errors (MAEs) are relatively frequent occurrences, and can have serious consequences. There is mixed evidence as to whether they can be reduced through a two-nurse administration system. Two-nurse administration is relatively expensive, but could be more cost-effective if the second administrator were a specially trained health care assistant (HCA) rather than a registered nurse. Such a system may also be more practicable in areas where only one registered nurse is available. This paper describes the evaluation of the introduction of an HCA observer into the medicines administration process utilising a before and after audit design. There was a significant fall in the MAE rate 9 months after the introduction of an observer, from 2.92% to 0.85% of all prescribed doses.

Little is known about the experiences of male patients in secure mental health and intellectual disability units during environmental transition. We interviewed patients before (n = 9) and after (n = 8) a side-to-side security transition from medium-secure wards in an older building to new wards in a purpose-built building. We inquired about transitional experiences in general and about this transition specifically. We examined interview transcripts and field notes using thematic analysis, and collated routine outcome data to gauge whether transition had obvious positive or negative effects. Qualitative analysis indicated three major themes (information, transition, and behaviour) and five overlapping subthemes (positive information sharing and consultation, concerns and anxieties about lack of information, life change and opportunity, home and sense of belonging, and potential conflict). Outcome data indicated little obvious change between first and second interviews. Expressed concerns of patients about transition were largely about tangible and practical issues, including changes to rules, including smoking and prohibited items. The results highlight the need for the development of supportive patient-inclusion strategies, consistent and transparent communication processes, and a published timeframe during the planning and implementation phases of all types of transitional moves, including the side-to-side transfer of residents between accommodation buildings.

Purpose -This paper aims to review the need for and development of specialist deaf secure mental health services.Design/methodology/approach -The paper is a review article; it begins by giving a brief overview of deafness and the relationship between deafness, mental health problems and offending. Following this, relevant literature and Department of Health (DoH) guidance is summarised and a description of the current UK services is given.Findings -In 2001, Young et al. highlighted the needs of deaf mentally disordered offenders and the requirement for specialist forensic mental health services for this group. Since then several DoH guidance documents have been published that, amongst other things, highlighted the need to develop deaf forensic mental health services. There have now been substantial service developments in this area but substantial gaps remain -most notably, a lack of specialist mental health provision for deaf prisoners.Originality/value -The paper offers insights into the development and future of deaf forensic mental health services.

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