Gold I M, Wolfson E S, Lester C M, Ratey J J, Chmielinski H E
Massachusetts Mental Health Center, Harvard Medical School.
Hosp Community Psychiatry. 1989 Aug;40(8):836-40. doi: 10.1176/ps.40.8.836.
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 rehabilitative 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 staff's long-held perspectives about dual-diagnosis patients, lack of funding, and high staff turnover.
一段时间以来,患有智力发育迟缓与精神疾病双重诊断的患者已被视为一个独特的患者群体,但满足其特殊需求的项目发展缓慢。1986年10月,马萨诸塞州的一家精神病院在医院院区一个单独的拥有40个床位的病房区为这类患者开设了一个康复项目。所有被纳入专门的 habilitation and rehabilitation environment(SHARE)项目的患者都有长期住院治疗的历史,而且许多人已经接受了数年的抗精神病药物治疗。现在大多数患者参加日间项目,少数患者已经能够转入限制较少的环境。患者的平均抗精神病药物剂量已大幅降低。尽管存在诸如需要改变工作人员对双重诊断患者长期以来的看法、资金不足以及工作人员流动率高等项目发展问题,但仍取得了这一进展。