Oct 12, 2021
Dr. Debra A. Pinals, M.D., joins Dr. Dixon and Dr. Berezin to
discuss two forthcoming articles from Psychiatric Services
looking at persons with intellectual and developmental disabilities
in mental health systems. The first paper addresses clinical considerations, and
the second looks at policy and systems
Dr. Pinals is a Clinical Professor of Psychiatry and the
Director of the Program in Psychiatry, Law, and Ethics at the
University of Michigan Medical School in Ann Arbor, Michigan.
Topics discussed in this episode:
- Mental health systems and law enforcement
- Medicaid-funded and state-funded systems
- Defining the patient population
- “Beyond Beds” and the psychiatric continuum of care
- Seeing the population beyond just crisis
- Dealing with aggressive behavior and overmedicating the
- Restricting individual autonomy as a last resort
- Applied Behavioral Analysis
- Overlooked stressors and potential drivers of crisis
- Role of evidence-based practices in this population
- Distinguishing between mental illness and intellectual
disabilities, and how they interact
- Encouraging communication across systems
- Expansion of crisis services
- Rehabilitation services versus habilitation services
- Where does neurology fit in?
- What system does care take place in?
- How do we improve things from here?
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