Mental illness-mental retardation in the United States: policy and treatment challenges.
Big hospital shutdowns left people with dual diagnosis in the lurch—pair new ACA dollars with blended ID-psych teams to close the gap.
01Research in Context
What this study did
Crosbie (1993) looked at what happened after big hospitals closed. The paper maps US policy gaps for people who have both intellectual disability and mental illness. It lists hurdles in assessment and shows early community models that looked promising.
What they found
The review found that moving people out of institutions created new cracks. Psychiatric care and ID services rarely talk to each other. The paper calls for teams that blend both kinds of help in one place.
How this fits with other research
Chaplin (2009) updates the same worry: general psych wards still lack staff who know ID. Caldwell (2010) shows the 2010 health law added money and rules that can fill the funding hole J flagged.
Robertson et al. (2014) gives a systematic thumbs-up to yearly health checks for people with ID, a concrete step J only hinted at.
Wong et al. (2018) extends the idea by mapping where supportive housing actually sits, showing scattered homes beat clustered settings for real neighborhood life.
Why it matters
You can stop waiting for a perfect system. Use the new money Caldwell (2010) unlocked to copy the blended teams J wanted. Add Janet’s yearly health check and Irene’s housing-spread rule. Together they give you a ready-made service package to pitch to your state or agency today.
Want CEUs on This Topic?
The ABA Clubhouse has 60+ free CEUs — live every Wednesday. Ethics, supervision & clinical topics.
Join Free →Schedule one joint case-review meeting with your local community mental-health center this month.
02At a glance
03Original abstract
The purpose of this paper is to present an overview of current trends in the field of dual diagnosis in the United States. Policy, programme, diagnostic and treatment issues are reviewed. The paper will examine the effects of the social policy of deinstitutionalization on people who have a dual diagnosis and will offer policy ideas for ameliorating some of the significant obstacles facing this population. Exemplary programme models are briefly discussed to illustrate the development of effective services. The challenges of assessing psychopathology in people with mental retardation are addressed. Several therapy and treatment modalities that have proven to be effective with people who have a dual diagnosis are also discussed. Lastly, this paper mentions a new community ideology driven by the values of consumers choice and satisfaction.
Journal of intellectual disability research : JIDR, 1993 · doi:10.1111/j.1365-2788.1993.tb00890.x