Clinical outcomes of a specialised inpatient unit for adults with mild to severe intellectual disability and mental illness

• Published in: Journal of intellectual disability research Vol. 54; no. 1; pp. 60 - 69
• Main Authors: Lunsky, Y., White, S. E., Palucka, A. M., Weiss, J., Bockus, S., Gofine, T.
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Publishing Ltd 01-01-2010; Wiley-Blackwell; Wiley Subscription Services, Inc
• Subjects: Adolescent; Adult; Adults; Behavioral Science Research; Canada; Clinical outcomes; Cognitive Ability; Combined Modality Therapy; Comparative Analysis; Cooperative Behavior; Developmental disabilities; Diagnosis, Dual (Psychiatry); Female; Follow-Up Studies; Foreign Countries; Health Needs; Health Services Needs and Demand; Hospitalization; Humans; inpatient; Inpatient care; Inpatient treatment units; Intellectual Disability; Intellectual Disability - diagnosis; Intellectual Disability - psychology; Intellectual Disability - therapy; Intelligence; Interdisciplinary Communication; Intervention; Learning disabilities; Length of Stay; Male; Mental Disorders; Mental Disorders - diagnosis; Mental Disorders - psychology; Mental Disorders - therapy; mental health; Mental Retardation; Mentally ill people; Middle Aged; Ontario; Outcome and Process Assessment (Health Care); Outcomes of Treatment; Patient Care Team; Patient Discharge; Patient Readmission; Patients; Psychiatric Department, Hospital; psychiatric disorders; Psychiatric Services; Psychiatry; Rehabilitation Centers; Severe Intellectual Disability; Studies; Young Adult; Canada; Ontario
• ISSN: 0964-2633; 1365-2788
• DOI: 10.1111/j.1365-2788.2009.01213.x

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.
Method  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.