[The new role of psychiatry in the management of mentally retarded patients].

Abstract

The areas of remedial education and special education have profoundly changed the psychiatric care of mentally retarded persons. Desinstitutionalisation, normalisation and integration are widely recognised concepts today and have since gained relatively substantial empirical support. Definition of these concepts has been broadened to include consideration of the optimal management of environmental conditions as an integral part of the comprehensive living environment. The systemic-ecological approach dislodges psychiatry from its central position in the treatment of the mentally ill retarded, and invests a greater degree of trust in remedial educations and special education. Effective treatment thus involves a joint effort on the part of various mental health professionals working towards a common goal, grounded on the coexistence of mental retardation and mental illness. Psychotherapy should be devised so as to address cognitive deficits no longer considered to be contraindicative to the therapy process. The purpose of pharmacotherapy is to finetune psychotropic medication with pedagogical, psychoeducational and psychotherapeutic methods. Although community-based mental health delivery systems and comprehensive (institutional based) services both show promise for the care and treatment of mentally retarded persons there is evidence for the particular viability of the latter model due to prevailing present conditions and to the aspect of cost effectiveness, particularly due to its utility in promoting still acquisition relevant to workers in this field of mental health.