A number of studies permit some empirically based analysis of the respective strengths and weaknesses of these two approaches to people with challenging needs/l2 Residential units have been shown to be capable of bringing about short-term behavioural change, can result in an improved quality of life, and may be viewed positively by unit staff and referring agents. Behavioural change is not guaranteed though, and further deterioration may even occur during admission. Behavioural recovery may not be evident upon returning the client to his or her normal environment. Receiving environments may be unable or unwilling to implement recommended interventions, and some people may be subject to multiple placements or admitted to highly restrictive placements after leaving the unit. Silting up, as a consequence of an inability to discharge residents, is also a potential problem.

Very different levels of effectiveness may also be evident both within and across different teams working in the community. Teams may also be prone to the problem of silting up (and hence fail to provide the coverage of specialist support required), may experience high rates of turnover of personnel, and may be unable to prevent placement breakdown in some of the referred cases.

There is still a paucity of evaluative research of psychiatric services for people with mental retardation. A study in Sweden (13) examined the prevalence of people with mental retardation admitted to general hospital psychiatric units and found a lower frequency of utilization as compared to the general population. Those people with mental retardation who had depression or were living on their own tended to have longer inpatient stays than those with other psychiatric diagnoses or living in supported accommodation.

Similarly, in The Netherlands, Driessen et al.(U examined the determinants of referrals to psychiatric services and the amount of consumed mental health services by people with mental retardation using a case register in a defined geographical area. Being older and having milder mental retardation predicted a higher probability of receiving psychiatric treatment, while living alone was associated with higher levels of mental health service consumption.

Of 400 new referrals to a British non-residential specialist mental health service 60 per cent had mild mental retardation, 40 per cent had a diagnosable mental illness, and 11 per cent required admission to an inpatient psychiatric unit. (11

Funny Wiring Autism

Funny Wiring Autism

Autism is a developmental disorder that manifests itself in early childhood and affects the functioning of the brain, primarily in the areas of social interaction and communication. Children with autism look like other children but do not play or behave like other children. They must struggle daily to cope and connect with the world around them.

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