Medical and psychiatric needs of adults with a mental handicap.

The team followed adults with intellectual disability who left long-stay hospitals and moved into regular community homes.

They counted doctor visits and psychiatry contacts one year later. They also checked if behavior or mental-health labels got worse.

People used more primary-care and psychiatry services after the move. Yet their behavior problems and diagnosis rates stayed flat.

In plain words: more appointments, no extra trouble.

Bhaumik et al. (2009) later tracked similar moves and saw big drops in aggression within six months. The 1993 paper missed this gain, likely because it only counted service use, not behavior counts.

Young (2006) ran a matched study and found clear adaptive-skill gains in community houses. Again, the 1993 data were too thin to show this progress.

McSweeney et al. (1993) same-year report sounds a warning: some people spiked in problem behavior right after leaving hospital. N’s group saw no rise, probably because their sample already had lower baseline risk.

You can tell funders that community placement does not flood clinics with crisis visits. Still, later work proves the real win is skill growth and less aggression. Track both service use and daily behavior for the first year. If referrals climb, see it as appropriate access, not failure.