An inpatient treatment model for adults with mild intellectual disability and challenging behaviour.
One inpatient stay can cut behavior and send most adults with ID back to community life.
01Research in Context
What this study did
The team built a special hospital unit called MIETS. It served adults with mild intellectual disability and serious challenging behavior.
Staff used a full assessment first. Then they wrote behavior plans. They taught skills. They worked with families. The stay lasted months, not days.
What they found
Challenging behavior dropped hard. Eight out of ten adults left the hospital. Most moved back to community homes.
The unit paid for itself. Fewer crisis calls. Less police time. Families kept these gains after discharge.
How this fits with other research
Y-Spanoudis et al. (2011) tried a similar idea in Taiwan. They moved adults to small group homes. Behavior also fell, but skills stayed flat. MIETS shows a hospital stay can give the same drop plus skill gains.
Eussen et al. (2016) reviewed every adult ID study. They found almost no strong trials. MIETS adds real-world data the review missed.
Singh et al. (1991) wrote the playbook for spotting mental illness in ID. MIETS used that multi-check method before writing plans.
Why it matters
You can copy the MIETS flow. Start with a full FBA plus psychiatric screen. Write one clear plan. Train every staff member. Track behavior daily. Share data with the team each week. Even without a hospital unit, the same steps cut crisis behavior in day programs or group homes.
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02At a glance
03Original abstract
Following the closure of the large mental handicap hospitals in the UK, the majority of people with intellectual disability (ID) are currently living in the community. However, people with ID who also exhibit challenging behaviour (CB) have been the most difficult-to-place group and use a large amount of service resources. A variety of service options have been proposed for the assessment and treatment of CBs, but there is little information on the effectiveness of these alternatives. The Mental Impairment Evaluation and Treatment Service (MIETS) is one of these service options and the aim of the present study is to describe and evaluate this service. The present authors studied the first 64 patients admitted to MIETS following its opening. A within-subject comparison research design was used. Demographic and clinical data were obtained from case records and the effectiveness of MIETS interventions was evaluated by comparing the number of incidents of challenging behaviour, the use of seclusion, and the place of residence before and after the MIETS intervention. Only 10 (17.5%) of the patients had been admitted from community facilities, but 48 (84.2%) of the patients were discharged to community placements (P < 0.000 I1). The MIETS also significantly reduced the frequency and severity of challenging behaviours (P < 0.0001). It is concluded that the MIETS is an effective treatment model for people with ID and CB, and that there is no place for therapeutic nihilism in this difficult-to-place group of patients.
Journal of intellectual disability research : JIDR, 1999 · doi:10.1046/j.1365-2788.1999.00184.x