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Specialized Inpatient Unit for Adults with Co-Morbid Mental Illness, Intellectual Disability, and Challenging Behavior

Kelly M. Vinquist, Shannon R. Walters, Jess G. Fiedorowicz and Jodi Tate
JHHSA, Vol. 45 No. 1, 24-44 (2022)

Individuals with intellectual disability (ID) often experience barriers accessing appropriate and effective healthcare. Our specialty program was established to provide interdisciplinary services across the continuum of care to patients with ID, co-morbid mental illness, and challenging behaviors by identifying the etiology of challenging behaviors and creating a comprehensive plan for treatment. We describe the structure of our inpatient specialty unit and a retrospective chart review completed to evaluate the combined impact on the prevalence of challenging behaviors as measured by the Aberrant Behaviors Checklist (ABC) and polypharmacy. Fifty-five patients were evaluated before and one month following 72 corresponding hospitalizations. Mean ABC scores improved from 69.5 to 54.7 (p=.02) with decreases in subscales for irritability, lethargy, hyperactivity, and inappropriate speech but not stereotypy. Total psychotropic medication use was reduced from a mean of 4.9 to 3.8 medications (p<.001). Our specialized interdisciplinary treatment approach appears to benefit many patients with complex needs.

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