# An investigation into the critical ingredients of intensive support teams for adults with intellectual disabilities who display challenging behaviour

## TL;DR

This study explores what factors influence the success of intensive support teams for adults with intellectual disabilities and challenging behaviors.

## Contribution

The study identifies individual factors, such as mental illness severity, as key to clinical outcomes in ISTs.

## Key findings

- Mental illness severity was the only variable linked to reduced challenging behavior.
- Accommodation type and gender influenced specific behavior subdomains like irritability and hyperactivity.
- Individual factors, not organizational ones, drive variation in clinical outcomes.

## Abstract

NHS England recommends the commissioning of intensive support teams (ISTs) to provide effective support to people with intellectual disability (ID) when in crisis. However, there is a paucity of evidence regarding how these services should be organised. This exploratory secondary analysis of data from the IST-ID study aimed to investigate IST characteristics that relate to clinical outcomes. The primary outcome was mean change in the total score on the Aberrant Behavior Checklist and its subscales.

A measure of mental illness severity was the only variable associated with our primary outcome of reduction in challenging behaviour. Accommodation type, affective status and gender were associated with the subdomains of irritability, hyperactivity and lethargy in unadjusted and adjusted analyses.

Our findings indicate that variation in clinical outcomes is influenced by individual rather than organisational factors. Further research on the theoretical fidelity of the IST-ID model is needed.