Clinical outcomes of a specialised inpatient unit for adults with mild to severe intellectual disability and mental illness.
BACKGROUND
Limitations of general psychiatric services have led to the development of specialised psychiatric programmes for patients with intellectual disability (ID) and mental health needs. Few studies have examined treatment outcomes of specialised inpatient units, and no studies have explored how the effects of intervention may differ for individuals at varying levels of cognitive ability. The present study examined clinical outcomes of inpatients with mild ID in contrast to inpatients with moderate to severe ID within the same service.


METHODS
Thirty-three patients (17 with mild ID and 16 with moderate to severe ID) discharged between 2006 and 2008 from a specialised inpatient unit in Canada for adults with ID and mental illness were studied. In addition to examining change in scores on clinical measures, outcomes with regard to length of stay, diagnostic change, residential change and re-admission to hospital were explored.


RESULTS
Both groups demonstrated clinical improvement from admission to discharge. However, only patients with mild ID demonstrated improvements on the Global Assessment of Functioning.


CONCLUSIONS
This study is one of the first to consider outcomes of higher and lower functioning individuals with ID on a specialised inpatient unit. Results suggest that outcomes may be different for these groups, and some clinical measures may be more sensitive to changes in patients with more severe disabilities.
Lunsky
Y
Y
Centre for Addiction and Mental Health, Toronto, Ontario, Canada. yona_lunsky@camh.net
White
S E
SE
Palucka
A M
AM
Weiss
J
J
Bockus
S
S
Gofine
T
T
D000293:Adolescent; D000328:Adult; D003131:Combined Modality Therapy; D003299:Cooperative Behavior; D017831:Diagnosis, Dual (Psychiatry); D005260:Female; D005500:Follow-Up Studies; D006301:Health Services Needs and Demand; D006801:Humans; D008607:Intellectual Disability / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D007360:Intelligence; D033183:Interdisciplinary Communication; D007902:Length of Stay; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D008875:Middle Aged; D009864:Ontario; D010043:Outcome and Process Assessment, Health Care; D010348:Patient Care Team; D010351:Patient Discharge; D010359:Patient Readmission; D011567:Psychiatric Department, Hospital; D012047:Rehabilitation Centers; D055815:Young Adult