Overall Goals of Psychiatric Treatment of Persons with Mental Retardation

Overall Goals of Psychiatric Treatment of Persons with Mental Retardation

The most common mistake made by mental health clinicians treating persons with mental retardation is to consider suppression (usually with medications) of single problems (as a rule disruptive behaviors) as the only goal of treatment. This approach used to be the rule in the past when people with mental retardation were not expected to achieve any measure of independence and keeping them docile was the goal. Lately such approaches are reemerging, partly related to the insurer’s pressure to achieve a fast and inex-pensive symptomatic improvement, even if short lived.

The goal of any form of psychiatric treatment of persons with mental retardation is to contribute to this sense of satisfac-tion with one’s own life, or happiness, in the context of a compre-hensive treatment program. Suppression of behaviors inconven-ient to caregivers is not enough, especially if they are a response to an inadequate habilitation program and the treatment (usually medications) is used in lieu of such program. Furthermore, medi-cations may suppress a person’s functioning through side effects such as drowsiness. The mental health clinician should not as- sume that “nonpsychiatric” problems are taken care of by some-one else, but should take an active part in the team’s assessment of various factors contributing to the clinical presentation, as well as the person’s need for various supports. This is not to say that the psychiatrist should be in charge of behavioral modifica-tion or vocational rehabilitation, but that these approaches should be closely coordinated with specific psychiatric treatments and should be targeted toward the common therapeutic goal.