An inpatient treatment model for adults with mild intellectual disability and challenging behaviour

Following the closure of the large mental handicap hospitals in the UK, the majority of people with intellectual disability (ID) are currently living in the community. However, people with ID who also exhibit challenging beha viour (CB) have been the most difficult-to-place group and use a large amou nt of service resources. A variety of service options have been proposed fo r the assessment and treatment of CBs, but there is little information on t he effectiveness of these alternatives. The Mental Impairment Evaluation an d Treatment Service (MIETS) is one of these service options and the aim of the present study is to describe and evaluate this service. The present aut hors studied the first 64 patients admitted to MIETS following its opening. A within-subject comparison research design was used. Demographic and clin ical data were obtained from case records and the effectiveness of MIETS in terventions was evaluated by comparing the number of incidents of challengi ng behaviour, the use of seclusion, and the place of residence before and a fter the MIETS intervention. Only 10 (17.5%) of the patients had been admit ted from community facilities, but 48 (84.2%) of the patients were discharg ed to community placements (P < 0.0001). The MIETS also significantly reduc ed the frequency and severity of challenging behaviours (P < 0.0001). It is concluded that the MIETS is an effective treatment model for people with I D and CB, and that there is no place for therapeutic nihilism in this diffi cult-to-place group of patients.