Discharging inpatients with intellectual disability from secure to community services: risk assessment and management considerations

Purpose: There is increasing emphasis on caring for people with intellectual disabilities in the least restrictive, ideally community settings. Therefore, the purpose of this paper is to explore the risk factors considered by clinicians involved in discharging people from secure services. Design/methodology/approach: The views of five senior clinicians were sought in semi structured interviews. Data were analysed thematically. Findings: Themes related to risk assessment, risk management, and multidisciplinary and multiagency working. Illustrative quotes are used to evidence themes. Practical implications: This study described the risk assessment and management factors considered during the discharge of patients from secure to community services, which are of direct relevance to multiple stakeholders post-Winterbourne. Originality/value: Challenges when facilitating discharge were highlighted, such as ongoing risk management issues, or unexpected discharge from tribunals, and how these were addressed, via the development of extensive risk assessment and management processes, and interdisciplinary and interagency working.