46: Persons With Intellectual and Developmental Disabilities in the Mental Health System: Clinical, Policy and Systems Considerations

Psychiatric Services From Pages to Practice

Dr. Debra A. Pinals, M.D., joins Dr. Dixon and Dr. Berezin to discuss two forthcoming articles from Psychiatric Services looking at persons with intellectual and developmental disabilities in mental health systems. The first paper addresses clinical considerations, and the second looks at policy and systems considerations.

Dr. Pinals is a Clinical Professor of Psychiatry and the Director of the Program in Psychiatry, Law, and Ethics at the University of Michigan Medical School in Ann Arbor, Michigan.

Topics discussed in this episode:

• Mental health systems and law enforcement
• Medicaid-funded and state-funded systems
• Defining the patient population
• "Beyond Beds" and the psychiatric continuum of care
• Seeing the population beyond just crisis
• Dealing with aggressive behavior and overmedicating the population
• Restricting individual autonomy as a last resort
• Applied Behavioral Analysis
• Overlooked stressors and potential drivers of crisis
• Role of evidence-based practices in this population
• Distinguishing between mental illness and intellectual disabilities, and how they interact
• Encouraging communication across systems
• Expansion of crisis services
• Rehabilitation services versus habilitation services
• Where does neurology fit in?
• What system does care take place in?
• How do we improve things from here?

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