Reasons for referral, intervention approaches and demographic characteristics of clients with intellectual disability attending adult psychiatric outpatient services in the Kingdom of Bahrain.
In Bahrain, every adult with ID who sees a psychiatrist gets only medication—no behavior help at all.
01Research in Context
What this study did
Doctors in Bahrain looked at every adult with intellectual disability who came to outpatient psychiatry.
They counted 79 adults over one year.
They wrote down why each person was sent and what treatment they got.
What they found
Every single adult left with only pills.
No one got behavior therapy, skills training, or family coaching.
The top reason for referral was "behavioral disturbance" like hitting or yelling.
How this fits with other research
Tsakanikos et al. (2007) saw the opposite trend in the UK.
Referrals rose, but medication use at first visit dropped.
This shows Bahrain is far behind current practice.
Cox et al. (2022) found that changing behavior plans cut problem behavior more than changing meds.
This directly challenges Bahrain's drug-only model.
Li et al. (2025) also used lots of meds, but only in kids with autism who were in crisis.
The adults in Bahrain got drugs even without crisis, showing a different standard of care.
Why it matters
If you work with adults who have ID, this paper is a red flag.
It shows a place where behavior analysis is missing from mental health care.
You can advocate for adding FBA or ACT services.
Start small: offer one functional assessment slot per week at the local clinic.
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02At a glance
03Original abstract
BACKGROUND: Relatively little information is available regarding the use of psychiatric services by individuals with intellectual disability (ID) in Arab countries. The current study aimed to identify (1) the reasons for referral; (2) demographic characteristics of individuals referred; (3) previous contact with child psychiatric services; (4) psychiatric diagnoses; (5) level of ID; (6) nature of interventions; and (7) patterns of medication usage in individuals attending a specialist psychiatric service for individuals with an ID in the Kingdom of Bahrain. METHOD: Case file analysis was used. Files that recorded attendance at the specialist service within a specific calendar year were selected. A total of 537 files were available for review and 79 contained records indicating the individual had been seen within the year. RESULTS: The primary referral reason to adult psychiatric services was the presence of behavioural disturbance. Pharmacological intervention was the dominant treatment choice and no individual was recommended for psychological/behavioural intervention. Psychiatric diagnosis was not recorded in over 90% of cases. CONCLUSION: Services in the Kingdom of Bahrain for individuals with ID rely exclusively on pharmacological approaches for the treatment of behavioural disorders. Implications for best practice guidelines are discussed.
Journal of intellectual disability research : JIDR, 2015 · doi:10.1111/jir.12077