Comprehensive Management of the Mentally Retarded/Mentally Ill Individual

Abstract

The management of the developmentally disabled population is difficult, and many professionals have devoted time and energy for methods to deal effectively with the individual problems presented by this population. In the person with both mental retardation and mental illness, the presenting clinical problems are more magnified and complicated. Therefore, this “dual diagnosis” population, which has been well addressed in other chapters in this section, tends to fall between the cracks since so few professionals want to deal with them, even in the medical field. These dually diagnosed individuals tend to get shuffled between the mental retardation and the mental health facilities, and few professionals claim acceptance for the full responsibility of their management. The purpose of this chapter is to offer the reader a descriptive analysis of both the diagnosis and management of this subpopulation from a developmental perspective. This approach perhaps differs from the other programs managed by psychiatrists and described throughout this book (e.g., Menolascino in Nebraska, Gualtieri in South Carolina, and Szymanski and Sovner in Boston), not to mention the management of programs by psychologists (such as Gardner and Matson), in that it does not take place in a large research-training-service facility. While such isles of excellence are essential, the less fortunate facilities may be tempted to despair with their own limitations. Hopefully, this brief chapter on how to establish an affordable and available team approach will be encouraging to the practitioner.