Out-of-borough placements for people with learning disabilities

Sujeet Jaydeokar is a specialist registrar in the psychiatry of learning disabilities with Hertfordshire Partnership NHS Trust (St Peters’ House, 2 Bricket Road, St Albans, Hertfordshire AL1 3JW, UK). His research interests include the descriptive psychopathology and forensic issues of learning disabilities. Jack Piachaud is the Clinical Director of the Eric Shepherd Unit in Watford, Hertfordshire. He was the Medical Director of Horizon NHS Trust between 1998 and 2002, and has been a consultant psychiatrist in learning disabilities since 1981 and an honorary senior lecturer at St Mary’s and Imperial College London since 1987.

All people with learning disabilities should be able to choose from a variety of residential placements as a way of achieving greater community integration. However, many are still placed away from their borough of origin, resulting in complex consequences for them, and their families and for clinicians. This article explores the nature of the problem, defining the current issues, and examining the role of the stakeholders and the implications for psychiatrists working in this field.