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Developing a Unit for Mentally Retarded—Mentally Ill Patients on the Grounds of a State Hospital
Ilene M. Gold; Elisabeth S. Wolfson; Carolyn M. Lester; John J. Ratey; Hilary E. Chmielinski
Psychiatric Services 1989; doi:
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The authors particularly acknowledge the significant contributions of Heather Varnum, R.N., in the development of the SHARE program. They thank Edwin J. Mikkelsen, M.D., Gerald J. Billow, J.D., Jonathan F. King, and Allen Meyers, Ph.D., for reviewing the manuscript, and Gillian O'Driscoll, Barry Anderson, Karen Lindem, Miriam Blumenkrantz, and Peter Fielden, Ed.D., for their assistance.

Massachusetts Mental Health Center, Harvard Medical School, Charles River Hospital in Wellesley, Massachusetts

Medfield (Mass.) State Hospital

Harvard Medical School, Medfield State Hospital

Medfield State Hospital, Wrentham (Mass.) State School

1989 by the American Psychiatric Association

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For some time patients with the dual diagnosis of mental retardation and mental illness have been recognized as a distinct patient population, but development of programs meeting their special needs is slow. In October 1986 a Massachusetts state psychiatric facility opened a rebabilitative program for such patients in a separate 40-bed unit on the hospital grounds. All patients admitted to the Specialized Habilitative and Rehabilitative Environment (SHARE) program had long histories of institutionalization, and many had been treated with neuroleptic drugs for several years. Most patients now attend day programming, and a few have been able to move on to less restrictive environments. Patients' average neuroleptic dosage has been substantially reduced. This progress has been made in spite of such program-development problems as the need to change staffs long-held perspectives about dual-diagnosis patients, lack of funding, and high staff turnover.

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