Psychiatric Services for People With Mental Retardation

To the Editor: In an April 2002 review of articles on special populations that have been published in Psychiatric Services since 1950, Bell and Williamson (1) drew attention to the paucity of articles about people with mental retardation. They reported that no article on this topic had been published in at least the past ten years. That was a matter of surprise to me, because I had been reading a series of articles on people with mental retardation who used generic psychiatric services when I came across two relevant studies in Psychiatric Services.

In 1995 the journal published a study by Patterson and colleagues (2) that described an evaluation of a system aimed at reducing hospitalization of people with mental retardation in Washington State. In 1997 Dudley and associates (3) reported on the satisfaction of patients with mental retardation after they were discharged from state psychiatric hospitals into community placements in North Carolina. The criteria used by Bell and Williamson are not clear, because they did not include these articles in their review.

Although I did not formally check for other articles in Psychiatric Services, I performed electronic and manual searches for articles on patients with mental retardation in Psychiatric Bulletin. In the United Kingdom, mental retardation was referred to formerly as "mental handicap" and more recently as "learning disability." Psychiatric Bulletin, which is published by the Royal College of Psychiatrists in the United Kingdom, is the "sister journal" of Psychiatric Services. It publishes research reports on treatment, administration, training, and management of psychiatric services. Of 1,633 articles published in the past eight years, 42 (3 percent) focused on people with learning disabilities. This is bound to be an underestimate, because letters to the editor were counted as articles and were not included in my search.

I hope that this letter will stimulate trans-Atlantic interest in the much neglected area of research on service provision for this population, which has higher than average needs for mental health care.

Dr. Chaplin is a consultant in general adult psychiatry for the Oxfordshire Mental Healthcare NHS Trust in Oxford, United Kingdom.