A novel care pathway for prisoners with intellectual disability designed through a Delphi process

Area of Science:

• Forensic Psychiatry
• Intellectual Disability Services
• Criminal Justice Health

Background:

• Intellectual disability (ID) affects a significant portion of prison populations globally.
• Existing specialist services for prisoners with ID require development.
• There is a need for structured management approaches for this demographic.

Purpose of the Study:

• To propose a novel care pathway for the assessment and management of prisoners with intellectual disabilities.
• To establish consensus among experts on key management considerations.
• To address the lack of decision-making tools for this specific setting.

Main Methods:

• A Delphi exercise involving 10 experts in forensic intellectual disabilities.
• Semi-structured questionnaires were used to elicit expert views.
• Content analysis via NVivo 11 software, followed by consensus-building on a proposed care pathway.

Main Results:

• Expert consensus was reached on a comprehensive care pathway for prisoners with ID.
• Current care provision was identified as limited and inconsistent.
• The vulnerability of prisoners with ID and the need for community-equivalent care were highlighted.

Conclusions:

• The proposed care pathway offers a structured approach to managing prisoners with ID.
• Multidisciplinary input and specialist placements are crucial for diversion and care.
• The pathway, while Irish in origin, provides internationally relevant guidance.