Nick Bouras's research while affiliated with ICL and other places
What is this page?
This page lists the scientific contributions of an author, who either does not have a ResearchGate profile, or has not yet added these contributions to their profile.
It was automatically created by ResearchGate to create a record of this author's body of work. We create such pages to advance our goal of creating and maintaining the most comprehensive scientific repository possible. In doing so, we process publicly available (personal) data relating to the author as a member of the scientific community.
If you're a ResearchGate member, you can follow this page to keep up with this author's work.
If you are this author, and you don't want us to display this page anymore, please let us know.
It was automatically created by ResearchGate to create a record of this author's body of work. We create such pages to advance our goal of creating and maintaining the most comprehensive scientific repository possible. In doing so, we process publicly available (personal) data relating to the author as a member of the scientific community.
If you're a ResearchGate member, you can follow this page to keep up with this author's work.
If you are this author, and you don't want us to display this page anymore, please let us know.
Publications (113)
The fiftieth anniversary of the Royal College of Psychiatrists, and the publication of a detailed multidisciplinary social history of British psychiatry and mental health in recent decades have offered an opportunity to take a helicopter view and reflect on the relation between psychiatry and changing British society. We argue that the time has com...
Offending in people with intellectual disability (ID) and/or autism spectrum disorder (ASD) is poorly understood. The evidence suggests that people with ID and/or ASD may be overrepresented in the criminal justice system and their presence is associated with an increased likelihood of future recidivism and custodial or more restrictive or punitive...
The ongoing debate for the past 30 years has been on the model of mental health services for people with intellectual disability (ID), specifically around how these services should be delivered. A strategic approach could have been more effective in ensuring care pathways that connect the various agencies of health, social care, support and educati...
The period 1960–2010 has been one of marked change in UK society and mental health services. Prominent changes have included deinstitutionalisation and community care in mental health. These have taken place in an evolving framework of liberalisation, marketisation and globalisation. The global financial crisis of 2008 and the increasing impact of...
Mind, State and Society examines the reforms in psychiatry and mental health services in Britain during 1960–2010, when de-institutionalisation and community care coincided with the increasing dominance of ideologies of social liberalism, identity politics and neoliberal economics. Featuring contributions from leading academics, policymakers, menta...
Mind, State and Society examines the reforms in psychiatry and mental health services in Britain during 1960–2010, when de-institutionalisation and community care coincided with the increasing dominance of ideologies of social liberalism, identity politics and neoliberal economics. Featuring contributions from leading academics, policymakers, menta...
The Camberwell Assessment of Need for adults with Developmental and Intellectual Disabilities (CANDID) is a widely used tool for the assessment of health and social needs of people with intellectual disabilities and mental health problems. It uses the assessment approach adopted by CAN, the world's leading mental health needs assessment measure. Tw...
Service provision in the United Kingdom (UK) for those individuals with intellectual and developmental disabilities (IDD) and coexisting mental health problems remains unfunded and under-developed. Heavily determined by widespread and enduring dualistic thinking, leading patients to bounce between mental health and IDD services. Community services...
Since the 1960s, we have witnessed the development and growth of community mental health care that continues to dominate mental health policy and practice. Several high-income countries have implemented community mental health care programmes but for many others, including mostly low- and middle-income countries, it remains an aspiration. Although...
Maudsley International was set up to help improve people's mental health and well-being around the world. A variety of programmes have been developed by Maudsley International over the past 10 years, for planning and implementing services; building capacity; and training and evaluation to support organisations and individuals, professionals and man...
There has been an increasing awareness of the importance of leadership and decision making, including scientists and academics, over recent times. By whom and how decisions are made can have serious implications across all levels of society. Several people have been successful in their life and have been inflicted by excessive pride and self-confid...
![Figure][1]
James (Jim) Watson, who died after a stroke on 3 August 2016 aged 80, was among a small band of British psychiatrists who trained in the 1960s and 70s to take psychiatry out of the asylums and establish robust services in general hospital and community settings. They were also
Introduction: This article introduces the SAINT (Self-Assessment and INTervention), a guided self-help intervention for the treatment of mild depression in people with intellectual disabilities. Method: The study used a single-case experimental design and adopted quality frameworks specific to the approach to describe the participants and to standa...
Fully revised, this new edition reviews the most up-to-date and clinically relevant information on the mental health and behavioral problems of people with intellectual, developmental and learning disabilities, also previously known as mental retardation. Providing the latest evidence base from the literature and embracing clinical experience, it c...
Smjernice počinju kratkim prikazom prevalencije psihičkih poremećaja u odraslih osoba s intelektualnim teškoćama a potom se razmatraju neka važna načela u procjeni takvih osoba. Slijedi poglavlje o pojedinim psihičkim poremećajima u ovoj skupini, s posebnim osvrtom na to kako intelektualne teškoće mogu utjecati na izražavanje simptoma psihičkih por...
The commissioning and provision of healthcare, including mental health services, must be consistent with ethical principles - which can be summarised as being "fair", irrespective of the method chosen to deliver care. They must also provide value to both patients and society in general. Value may be defined as the ratio of patient health outcomes t...
The systematic review by Papoulias et al [1][1] on the psychiatric ward as a therapeutic space reminds us of the important effects of environmental factors on in-patients. The physical environment is likely, however, to be particularly significant in settings where length of stay is long, whether in
Introduction: Autism spectrum disorder (ASD) affects 20-30% of adults with intellectual disability. This group are vulnerable to challenging behaviour and mental health problems.
Objectives: To explore the extent to which ASD affects challenging behaviour among specialist mental health service users with intellectual disability.
Aims: To identify...
Services for people with Intellectual Disability (ID) and coexisting mental health problems remain undeveloped; research into their effectiveness has been lacking. Three linked recent studies in the UK have provided evidence on essential service provision from staff, service users and carers. Interfaces with mainstream mental health services were s...
The closure of institutions has seen Western governments move at different paces towards community care for people with intellectual disability. For some specialist community mental health care for this group is still an aspiration. In the last 30 years a number of models to deliver community care, e.g. assertive outreach, intensive care and generi...
Purpose
– This study aimed to examine for differences on how symptoms relating to depression and anxiety were reported by males and females with intellectual disability as part of the development of the Self‐Assessment Intervention Package (SAINT), a guided self‐help tool.
Design/methodology/approach
– Three self‐report questionnaires were adminis...
This study investigated the main psychometric properties of the Self Assessment and Intervention (SAINT), a unique and recently developed Guided Self-Help tool for people with intellectual disabilities (ID). Fifty-four adults with ID identified with symptoms of anxiety and/or depression completed the study. They were between 18 and 77 years old wit...
Psychiatry, associated as it is with social and cultural factors, has undergone profound changes over the last 50 years. Values, attitudes, beliefs and ideology all influence psychiatry. Deinstitutionalisation, the normalization principle, advocacy, empowerment and the recovery model are ideologies that have been closely associated with policy, ser...
The Greek mental health system has been undergoing radical reforms for over the past twenty years. In congruence with trends and practices in other European countries, Greek mental health reforms were designed to develop a community-based mental health service system. The implementation of an extensive transformation became possible through the "Ps...
Over the last three decades significant efforts have been made in many European countries to move away from a mental health system dominated by institutional care towards one whereby the main emphasis is on providing care and support within the community. Although the time of starting the reforms, their pace, the political context, and the exact ob...
There is little information on the mental health needs of adults with intellectual disability (ID) and autism spectrum disorders (ASDs). Such evidence is much needed for the development of more effective mental health services for this group. The aim of this study is to compare adults with ID and ASD receiving specialist mental health services with...
The functioning of people with intellectual disability (ID) is affected by many factors. As well as their ID, their ability to communicate with others, their social competency, personality, life experiences and circumstances, and their health (including mental health) also influence their behaviour and adjustment. This chapter focuses on the develo...
Purpose
In spite of the greater prevalence of mental ill‐health in people with intellectual disabilities, there has been little work specifically aimed at how this group recognise threats to their mental health and the strategies used to minimise them. This study aims to look at the first stage of development of a guided self‐help (GSH) pack called...
The present study examined rates of co-morbid psychopathology and clinical management/care pathways in adult females (N = 50) and males (N = 100) with autism spectrum disorders (ASD) and intellectual disability (ID) living in community settings. We also compared a sub-sample (N = 60) with ASD to an age-, gender- and ID-matched control group (N = 90...
Although epilepsy is particularly common among people with intellectual disability (ID) it remains unclear whether it is associated with an increased likelihood of co-morbid psychopathology. We therefore investigated rates of mental health problems and other clinical characteristics in patients with ID and epilepsy (N = 156) as compared to patients...
People with intellectual disability often have health needs that go unrecognised and untreated; this may be because of difficulties in communication, diagnostic overshadowing, discrimination or indifference. There is concern that public health measures aimed at reducing the main health killers in the population will not address these issues for peo...
We investigated the relationship between challenging behavior and co-morbid psychopathology in adults with intellectual disability (ID) and autism spectrum disorders (ASDs) (N=124) as compared to adults with ID only (N=562). All participants were first time referrals to specialist mental health services and were living in community settings. Clinic...
The objective of this study was to explore whether people with intellectual disability from ethnic minority groups have higher rates of mental health problems and access different care pathways than their White counterparts. Clinical and socio-demographic data were collected for 806 consecutive new referrals to a specialist mental health service fo...
The aim of this study was to investigate co-morbid psychopathology and clinical characteristics of adults with ID living across different types of residential settings. All participants were first time referrals to specialist services in South-East London who lived either with their family (N=375) or in supported residence (N=280) or independently...
Three separate focus groups were conducted to compare the views of service users, carers and specialist health professionals on community services for adults with psychosis and learning disabilities. Participants were asked which staff, treatments or interventions and methods of working or style of service organisation make a significant contributi...
Aggressive challenging behaviour in people with intellectual disability (ID) is frequently treated with antipsychotic drugs, despite a limited evidence base.
A multi-centre randomised controlled trial was undertaken to investigate the efficacy, adverse effects and costs of two commonly prescribed antipsychotic drugs (risperidone and haloperidol) an...
Accessible summary
This research was about people with learning disabilities who went into hospital when they had mental health problems.
We looked at when they went into ordinary mental health units and also into a special unit for people who also have learning disabilities.
We looked at what their mental health problems were and how long they sta...
To assess the effects and cost-effectiveness of haloperidol, risperidone and placebo on aggressive challenging behaviour in adults with intellectual disability.
A double-blind randomised controlled trial of two drugs and placebo administered in flexible dosage, with full, independent assessments of aggressive and aberrant behaviour, global improvem...
The aim of the present study is to investigate the association between recent life events and traumatic experiences across the life span and psychiatric disorders in people with ID. One hundred seventy-seven individuals with mild and moderate intellectual disability and their principal carers were assessed. Psychiatric disorders were evaluated with...
Accessible summary
This paper looks at how care is given to people with intellectual disability who have mental health problems.
The paper looks at care since Valuing People came out in 2001.
It shows there are not enough services for people with intellectual disability who have mental health problems.
It shows there are not enough services for peo...
Background Previous evidence has suggested that clinical characteristics may predict use of restraint in adults with intellectual disability. However, the relationship between specific types of untoward incidents, corresponding interventions (restrictive procedures) and clinical psychopathology remains unclear.
Method We examined all untoward incid...
There remains a severe lack of evidence on the effectiveness of community services for adults with psychosis and intellectual disabilities (ID). There has been little consensus even of what services should provide for this service user group.
A consultation of multidisciplinary professionals was carried out by using a three-round Delphi exercise. P...
There are high rates of emotional, behavioural and psychiatric problems (Cooper et al, 2007) in the learning disability population. This paper describes the Mental Health in Learning Disabilities (MHiLD) service for adults with learning disabilities in four South London boroughs. This service has been in operation in two South East London boroughs...
Associations between demographic and clinical variables and severe behavioural problems in people with intellectual disabilities were examined in a cross-sectional survey of 408 adults consecutively referred to a specialist mental health service. Severe behavioural problems were present in 136 (33.3%) of the sample. The demographic and clinical pre...
Aggressive challenging behaviour is frequently reported in adults with intellectual disability and it is often treated with antipsychotic drugs. However, no adequate evidence base for this practice exists. We compared flexible doses of haloperidol (a typical, first-generation antipsychotic drug), risperidone (an atypical, second-generation antipsyc...
Services for people with intellectual disabilities, in the UK as elsewhere, have changed dramatically over the last 30 years; deinstitutionalisation has probably been the largest experiment in social policy in our time. The vast majority of people with intellectual disabilities, their families and carers have benefited from having a better quality...
Cultural psychiatry is concerned with understanding the impact of social and cultural differences and similarities on mental illness and its treatments. A person's cultural characteristics can often lead to misunderstandings, influenced by language, non-verbal styles, codes of etiquette and assumptions. There may also be perceived misconceptions an...
An abstract is unavailable. This article is available as HTML full text and PDF.
Background Although research is starting to identify those factors that predict contact with mental health services in individuals with intellectual disabilities, very little is known about the patterns of service use following referral. Yet, this information is vital for effective service planning and development. We therefore examined the factors...
We examined behaviour management problems as predictors of psychotropic medication, use of psychiatric consultation and in-patient admission in a group of 66 adults with pervasive developmental disorder (PDD) and intellectual disability (ID) and 99 controls matched in age, gender and level of ID. Overall, people with PDD had higher rates of most DA...
Background Care staff play a key role in identifying individuals with intellectual disabilities and additional mental health problems. Yet, few receive training in mental health, and evidence about the effectiveness of training is scant.
Materials and Methods A pre–post study is reported, using a mental health screen and a self‐report questionnaire...
Summary of findings Introduction People with intellectual disabilities (ID) have higher rates of mental disorders compared to people of more typical intelligence (Smiley, 2005). They can experience the full range of psychotic disorders seen in the wider population (Reid, 1972). However, the evidence base regarding the epidemiology, etiology, assess...
Researchers have paid increasing attention to mental health issues in adults with autism spectrum disorders (ASDs) over the last decades. However, little is known about how rates of clinical referrals, types of mental health diagnoses and treatment in adults with ASDs and intellectual disability have changed. We examined patterns of change in refer...
Relatively few studies have examined the impact of life events on mental health in the field of intellectual disability (ID), despite the possibility that adults with ID and mental health problems might be particularly vulnerable to multiple events.
To examine the impact of multiple life events on mental health in people with ID.
The sample consist...
Entirely revised and updated, this new edition of a very well-received and successful book provides the essentials for all those involved in the fields of intellectual, developmental and learning disabilities and mental retardation, drawing both on clinical experience and the latest research findings. An international, multidisciplinary team of exp...
There have been few studies of psychopathology in adult with autism. This study examined psychiatric co-morbidity in 147 adults with intellectual disability (ID) and autism and 605 adults with ID but without autism. After controlling for the effects of gender, age, psychotropic medication and level of ID, people with autism and ID were no more like...
Although gender differences in psychopathology among the general psychiatric population appear to be well documented, such differences have been either ignored or inconsistently investigated among people with intellectual disability (ID).
The study examined psychiatric co- morbidity in 295 men and 295 women with ID and significant social impairment...
Previous studies have suggested different patterns of associations between psychiatric symptoms and problem behaviours in people with intellectual disabilities (ID). The aim of this study was to investigate which problem behaviours are associated with specific psychiatric symptoms and the relative strength of these specific associations.
A cross se...
There is a certain amount of ambiguity and confusion over the provision of mental health services for people with intellectual disabilities (ID) referred by both primary care services (primary care (PC)/social services (SS)) and secondary care services (generic mental health services (GMHS)). Psychosocial and clinical characteristics of new referra...
Although it is widely accepted that individuals with intellectul disabilities face an increased vulnerability to developing mental health problems, there is currently a lack of agreement about the most appropriate form of assessment. When applied to people with intellectual disabilities, there is no consensus about which problems should be included...
Background Although there is already information available about caring for someone with a mental health problem, there is very little written for families and carers of people with intellectual disabilities.
Materials and methods This paper describes the development of a Guide as such a resource. The consultation stage involved interviews and focu...
Previous research has shown that around one-third of inpatients in high secure units are in a level of security incommensurate with their actual need. In this article we show that in a cohort of 200 inpatients in low secure units in a region of England, one third were assumed to be in an inappropriate level of security; most of these were thought t...
Assertive community treatment (ACT) has been applied to a number of disorders in the adult population, such as schizophrenia, with some degree of success; its use in the treatment of people with intellectual disability (ID) and mental illness has received little attention. Despite the high costs of ID in health and social care, there has been very...
Information on admission to psychiatric inpatient units is lacking from the literature on contemporary services for people with intellectual disability and mental health needs. Here we report on predictors of admission for a cohort of 752 adults from this population living in community settings; 83 were admitted. We also report on two subsamples of...
The development of reliable, valid measures of psychopathology in people with intellectual disabilities is an important task. However, independent replication studies are rarely reported.
To report data on the psychometric properties of the Psychiatric Assessment Schedule for Adults with Developmental Disabilities (PAS-ADD) Checklist.
The PAS-ADD C...
Although there is an increased risk of schizophrenia-spectrum psychoses (SSP) in people with intellectual disability (ID), there is a paucity of research evidence into clinical presentation of the disorder in comparison with research into SSP in people without ID.
The aims of the study were to compare clinical, functional, and social factors in pat...
Services for people with learning disabilities have been transformed since the late 1960s by the move from institutional to community care. (Learning disabilities is the term currently used in the UK in preference to mental retardation, developmental disabilities and mental handicap.) Important changes include the progress towards integration, part...
This article considers variables associated with the presence of a psychiatric diagnosis in those referred to a specialist mental health service for people with mental retardation (MR). Data were collected on 752 newly referred clients. The presence of a psychiatric diagnosis was assessed by two psychiatrists based on International Classification o...
When adults with intellectual disabilities (ID) require a psychiatric admission, general adult mental health units are often used. Specialist units have emerged recently as a care option but there is only limited evidence of their effectiveness. Thus this study aims to describe and evaluate the effectiveness of a specialist inpatient unit and repor...
Atypical antipsychotics are the first-line treatment for psychosis and are commonly used for behavioural problems in people with intellectual disabilities (ID), but a comprehensive evidence base for this approach is lacking. We studied prescription trends and the clinical effectiveness of risperidone and olanzapine in people with ID in a clinical,...
The Specialist Mental Health Service for people with an intellectual disability (ID) and psychiatric disorder (referred to throughout this paper as 'the Service') has been in operation in south-east London for the last 18 years, during which time two local, long-stay institutions have closed.
To measure the number of referrals to the Service from 1...
This paper outlines the main developments in five European countries (Austria, England, Greece, Ireland and Spain) in services to meet the mental health needs of people with learning disabilities (dual diagnosis). Each country has a unique historical perspective, which has led to varying policies and legislation and different patterns of service de...
The aim of the present paper is to describe and compare services for adults with intellectual disability (ID) and mental health needs in five European countries: Austria, England, Greece, Ireland and Spain. A framework and structure for collecting information about service provision was designed. This information was collected through a mixture of...
The present paper discusses the application of the 'matrix model' to mental health services for people with intellectual disability. There is great variability between the service models in this area, which makes comparisons and conclusions difficult. The present model facilitates the breaking down of these complexities into understandable parts so...
Citations
... For example, the meaning parents attach to their childrens' symptoms and their associated beliefs about the symptoms, causes, prognosis, and most appropriate path of care can be described within the context of that specific culture. After all, even the impact of disability is influenced by the sociocultural context in which the individual or the family lives (O'Hara & Bouras, 2007). Different cultural models of child rearing and child development exist in every society, in turn the attribution of meaning and understanding e.g., intellectual disability (ID) would vary greatly across cultures (ibid). ...
![[object Object]](https://i1.rgstatic.net/ii/profile.image/483139324780545-1492200799082_Q64/Jean-Ohara.jpg)
... 27 We also need to radicalise our political involvement with service user organisations, at both national and local level. 28 Neoliberalism has failed our patients. 29,30 Now that debate is underway on whether we are moving from neoliberalism to neo-or technofeudalism 31-33 there will likely be a need for further radicalisation in mental health, somewhat like Fanon and Basaglia although not identical. ...
![[object Object]](https://i1.rgstatic.net/ii/profile.image/339505136586755-1457955740828_Q64/George-Ikkos.jpg)
... Any of these symptoms can be observed regardless of language capabilities or level of intellectual disability, but the depression in persons with ID tends to be more insidious and changes seen may be less dramatic. 5 The symptoms include: ...
![[object Object]](https://i1.rgstatic.net/ii/profile.image/1159283282591746-1653406081885_Q64/Shoumitro-Deb.jpg)