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Primary care health checks, screenings and GP consultations are often the gateway for people with intellectual disabilities to access their physical and mental healthcare. For a population who experience greater levels of health difficulties alongside significant health inequality, improving care quality and access is of major importance. This meta-ethnographic, qualitative review aims to explore people with intellectual disabilities experiences of health checks, screenings and GP visits, while assessing the quality of the current literature and synthesising findings to consider clinical and research recommendations based on third order constructs. A systematic search identified 20 studies that met inclusion criteria. Quality assessment of each paper was conducted. Meta-ethnography methods were used to analyse and synthesis findings. One overarching concept was identified: Include Me, along with seven core concepts; Empowerment and Disempowerment, Communication and Interpersonal Factors, Access and Adaptations and Biased Narratives and Shifting Perspectives. Implications for practice and future direction are discussed.

The aim of this paper is to present the history of the people with intellectual disabilities' institutionalization, primarily in the USA, United Kingdom, and Germany, countries whose social policies were used as the role model for social policy in many other countries. The first part of the paper will provide information about the causes of intellectual disabilities, different classification of people and the purpose of the institutionalization in the period from the Middle Ages until the beginning of deinstitutionalization. The purpose of the institutionalization will be presented as the protection of people with intellectual disabilities and the protection of society from people with intellectual disabilities. Some aspects of education, labor and sterilization as important determinants of people with intellectual disabilities' life in institutions, basic aspects of history of institutionalization in Croatia and some information about the deinstitutionalization in the world are going to be presented in the second part of the paper. In the final part of the paper the answers about what has been changed during the history when it comes to the institutionalization of people with intellectual disabilities as a measure of social policy are going to be presented. The conclusion is that although the modern trends of deinstitutionalization ensure progress in the care of people with intellectual disabilities, many aspects of the institutionalization have been minimally changed during history. [ABSTRACT FROM AUTHOR]

Most electoral democracies, including forty-three states in the United States, deny people the right to vote on the basis of intellectual disability or mental illness. Scholars in several fields have addressed these disenfranchisements, including legal scholars who analyze their validity under U.S. constitutional law and international-human-rights law, philosophers and political scientists who analyze their validity under democratic theory, and mental-health researchers who analyze their relationship to scientific categories. This Note reviews the current state of the debate across these fields and makes three contentions: (a) pragmatic political considerations have blurred the distinction between disenfranchisement provisions based on cognitive capacity and those based on personal status; (b) proposals that advocate voting by proxy trivialize the broad civic purpose of the franchise; and (c) the persistence of disenfranchisement on the basis of mental illness inevitably contributes to silencing socially disfavored views and lifestyles. Accordingly, the Note cautions reformers against advocating for capacity assessment or proxy voting, and emphasizes the importance of disassociating the idea of mental illness from voting capacity.

Background: Advances in health equity rely on representation of diverse groups in population health research samples. Despite progress in the diversification of research samples, continued expansion to include systematically excluded groups is needed to address health inequities. One such group that is infrequently represented in population health research are adults with intellectual disability. Individuals with intellectual disability experience pervasive health disparities. Representation in population health research is crucial to determine the root causes of inequity, understand the health of diverse populations, and address health disparities. The purpose of this paper was to develop recommendations for researchers to increase the accessibility of university health research and to support the inclusion of adults with intellectual disability as participants in health research. Methods: A comprehensive literature review, consultation with the university ethics review board, and review of United States federal regulations was completed to identify barriers to research participation for individuals with intellectual disability. A collaborative stakeholder working group developed recommendations and products to increase the accessibility of university research for participants with intellectual disability. Results: Eleven key barriers to research participation were identified including gaps in researchers' knowledge, lack of trust, accessibility and communication challenges, and systematic exclusion among others. Together the stakeholder working group compiled seven general recommendations for university health researchers to guide inclusion efforts. Recommendations included: 1) address the knowledge gap, 2) build community partnerships, 3) use plain language, 4) simplify consent and assent processes, 5) establish research capacity to consent, 6) offer universal supports and accommodations, and 7) practice accessible dissemination. In addition, four products were created as part of the stakeholder working group to be shared with researchers to support the inclusion of participants with intellectual disability. 1) Supports I Need Checklist, 2) Plain language glossary of health and research terms, 3) Understanding Consent and Assent in Plain Language, 4) Easy-Read Paper Template. Conclusion: Community members and individuals with intellectual disability want to be included in research and are eager to engage as research participants. It is the responsibility of the researcher to open the door to university health research. The recommendations discussed in this paper could increase accessibility for a broader range of research participants and, in particular, promote the inclusion of individuals with intellectual disability to advance health equity in population health research. [ABSTRACT FROM AUTHOR]

With there being a nine-and-a-half percent increase in prevalence of intellectual and/or developmental disabilities (IDD) among children in the U.S. over nine years (i.e., 2009-2017; Zablotsky et al., 2019), the number of adults with IDD in our communities is growing and there is great potential for CTRS to produce multi-level and infl uential opportunities, outcomes, and benefits for adults with IDD through therapeutic recreation (TR) services in community-based settings. However, community-based settings is not a well-represented employment setting among CTRSs in the U.S. Th is mixed methods study aimed to identify best practices, barriers, and facilitators CTRSs experience when providing TR services to adults with IDD in community-based settings, as well as to examine how COVID has impacted TR service delivery and ideas for future provision of virtual TR services among these CTRSs. A total of 278 CTRSs across the country who work with adults with IDD in community-based settings completed a Qualtrics survey and 15 of these CTRS completed a follow-up, individual interview. Integrated data analysis revealed widespread impacts of COVID, lack of use of evidence-based practice, lack of involvement in evidence-based practice research, and need for standardized assessment and use of evidence-based practice to increase billing for TR services. Important implications for TR service delivery among adults with IDD in community-based settings were revealed, as well as directions for future research. [ABSTRACT FROM AUTHOR]

The purpose of this qualitative study is to explore experiences of naturalistic interpersonal contact with persons with intellectual and developmental disabilities (IDD) and attitudes toward persons with IDD among Korean American adolescents and young adults. In interviews with 12 Korean American high school and college students, Korean American participants reported six common themes regarding their experiences of interpersonal contact with persons with IDD: 1) affective attitude, 2) behavioral attitude, 3) cognitive attitude, 4) communication with persons with IDD, 5) moments of having a positive attitude, and 6) comparisons of attitudes in the United States and Korea. Recommendations for research and practical implications are discussed. [ABSTRACT FROM AUTHOR]

Despite calls for reform of Article 17A guardianships for more than twenty-five years, the statute remains unchanged and New York routinely subjects adults with intellectual disabilities to open-ended, plenary guardianships with few, if any, procedural protections. As non-profit legal service providers working in a medical-legal partnership, hospitals refer to our organization, LegalHealth, clients who seek Article 17A guardianships over their loved ones. In this Essay, we discuss the many ways in which Article 17A fails to protect the rights of our clients' children, and the ethically compromised position practitioners are often put in while trying to both advocate for our clients (the Petitioners) and protect the ward (the Respondent). New York has another guardianship statute. Article 81, that, while not perfect, does a better job of protecting the rights of people with intellectual disabilities. Contrary to popular belief, Article 81 proceedings are not any more onerous than Article 17A proceedings. We suggest that the legislature either repeal Article 17A, leaving guardianships to proceed under Article 81, or reform Article 17A to align with protections afforded in Article 81. In the meantime, we suggest some solutions and practice guidelines that practitioners should follow in order to prevent undue violations of the civil liberties and due process rights of people with intellectual disabilities. [ABSTRACT FROM AUTHOR]

Background Care and support for people with intellectual and developmental disabilities (IDD) in natural community contexts are increasing. Many people with IDD use physical therapy services to support their community participation. Medicaid Home- and Community-Based Services (HCBS) 1915(c) waivers are the largest providers of long-term services and supports for people with IDD. However, little is known about physical therapy provision under this program. Objective The aim of this study was to compare the operational definitions of physical therapy service under the HCBS 1915(c) waiver system and to describe projected physical therapy service utilization, spending, and reimbursement for people with IDD across states. Design This was a cross-sectional, descriptive study. Methods This study analyzed fiscal year 2015 HCBS IDD waivers from across the nation (N = 111), focusing on physical therapy utilization (total projected spending, total participants, reimbursement rates, and average annual service provision per participant). Service definitions were also analyzed to determine trends across waivers. Results Fifty-one waivers (45.9%) provided 61 different types of physical therapy services in fiscal year 2015. States utilized waivers to provide long-term remedial care rather than the acute short-term physical therapy. HCBS waiver physical therapy services were often provided in participants' homes and communities to expand physical therapy access and secure the benefits of providing physical therapy services in natural environments. Although most states have adopted similar definitions of physical therapy service, procedures and services vary. Limitations Medicaid HCBS waivers are state projections made to the federal government rather than actual utilization data. Conclusions Physical therapy service definitions, projected service utilization, spending, and reimbursement for people with IDD who use Medicaid HCBS waivers vary greatly between states. Physical therapy may be utilized less than expected given the reported benefits for people with IDD. [ABSTRACT FROM AUTHOR]

Objective: To examine patterns and predictors of familiarity with transdisciplinary psychosocial (e.g., non-pharmacologic) practices for practitioners treating youths with autism spectrum disorder (ASD) in the United States. Method: Practitioners (n = 701) from behavioral, education, medical, and mental health backgrounds who worked with youth (ages 7–22) with ASD completed the Usual Care for Autism Survey, which assessed provider demographics and self-reported familiarity with transdisciplinary treatment practices for the most common referral problems of ASD. We examined relations between provider-, setting-, and client-level characteristics with familiarity of key groups of the treatment practices (practice sets). Practice sets were identified using exploratory factor analysis (EFA), and demographic predictors of practice subsets were examined using generalized estimating equations (GEE). Results: The EFA yielded a three-factor solution: (1) environmental modifications/antecedent strategies; (2) behavior analytic strategies; and (3) cognitive strategies, with overall familiarity ranked in this order. Medical providers indicated the least familiarity across disciplines. More experience with ASD and treating those with intellectual disabilities predicted greater familiarity with only environmental modifications/antecedent strategies and behavior analytic, but not cognitive strategies. Experience treating low SES clients predicted familiarity with environmental modification and behavior analytic strategies while experience treating high SES clients predicted familiarity with behavior analytic and cognitive strategies. Conclusion: This is the first study to identify transdisciplinary, interpretable sets of practices for treating youth with ASD based on community providers’ reported familiarity. Results highlight factors associated with familiarity with practice sets, which is essential for mapping practice availability, and optimizing training and dissemination efforts for youth with ASD. [ABSTRACT FROM AUTHOR]

The article discusses the social issues and challenges encountered of individuals with intellectual and developmental disabilities (IDD) and the social thought of catholic on cognitive disability. Topics discussed include the employment of adults with cognitive disabilities, the Supportive Housing program of U.S. Department of Housing and Urban Development (HUD) for people with disabilities, and the social status of people suffering from cognitive impairment during the 19th century.

The article discusses the author's views about police violence against people with mental disabilities and a duty under the Americans with Disabilities Act of 1990 (ADA) to reasonably accommodate mentally disabled people during the arrest process, and it mentions the ADA's nondiscrimination protections and different judicial interpretations of Title II of the ADA. A wrongful arrest theory and exigent circumstances are addressed, along with a direct threat exception.

The article highlights laws concerning criminal prosecution of individuals with mental illness, cognitive deficiencies, and/or developmental disabilities that impact the individual's capacity and criminal responsibility. It addresses needed reforms in the New York criminal justice system for individuals with disabilities and advocates for an increase in the use of alternative sanctions as well as the expansion of mental health courts and other diversion models.

All people, including individuals with intellectual and developmental disabilities (IDD) deserve to actively participate in the community in which they live. For transition aged-youth (TAY) with IDD, attaining successful community participation can be difficult. The purpose of this systematic review was to identify and synthesize the literature specific to recreational therapy interventions in the U.S. aimed at improving community participation among TAY with IDD. Literature specific to two domains of community participation were explored: a) interpersonal life; and b) community, civic and social life. Eight studies were reviewed using a thematic synthesis approach to identify common themes across studies. Findings revealed three themes: 1) programs with collaboration and community supports, 2) leisure education, and 3) social skills training. Facilitators, barriers, and promising approaches regarding community participation of TAY with IDD are described. Implications and limitations of the current literature are also addressed. [ABSTRACT FROM AUTHOR]

The article discusses the author's claim that the death penalty is disproportionately applied in cases involving persons with mental disabilities in America, and it mentions how issues such as prosecutorial misconduct, judicial bias, and passive judicial complicity can impact fairness and criminal justice administration in the U.S. Ineffective assistance of counsel claims and the potential misuse of mental disability evidence during a trial are examined, along with expert witnesses.

Nature-based physical activity programming (e.g., countryside walks, hiking, horseback riding) has been found to be an effective way to help improve the health of people with mental illness. Exercise referral initiatives, whereby health practitioners prescribe exercise in an attempt to prevent or treat chronic illnesses, have helped make such nature-based activities accessible to this population in the United Kingdom and Australia; however, there is a dearth of research related to the most prominent exercise referral program in the United States: Exercise is Medicine. Taking into account the barriers to physical activity faced by people with mental illness, we explore how nature-based programming for this population might be mobilized in the United States through the growing Exercise is Medicine initiative. [ABSTRACT FROM AUTHOR]

The article focuses on the response of police towards persons with mental disabilities in the U.S. Topics discussed include lack of training and misconceptions of illness by the public and by police officers making inappropriate arrests; enactment of Americans with Disabilities Act for preventing the human rights of persons with mental disabilities; and training of police officers for preventing the inappropriate arrests.

The article focuses on the competence of those with mental disabilities and their ability to consent to sex. Topics include the use of consent assessments to determine capacity, the laws governing those with mental disabilities, and the capacity of institutionalized persons. Information is provided on if the suppression of sexual desire is a form of social torture.

There are approximately 200 million individuals worldwide with intellectual disabilities, and in 2012, more than 4.2 million athletes in 170 countries benefited from SO programs and the 70,000 worldwide competitions. Although SO reaches millions on a yearly basis, there are still areas in the United States where potential athletes are either unaware of these opportunities or training clubs are not readily available. This paper will present the various opportunities that SO has to offer as well as the necessary steps for one to become a volunteer, certified coach, or even start their very own SO training club. [ABSTRACT FROM AUTHOR]

This introduction to the evaluation component of the Circles of Care initiative includes background on the nature of the initiative, Center for Mental Health Services support for developing systems of care for youth with emotional disturbances, and an overview of the systems of care approach. The prevalence, unique challenges, and the historical, political, and cultural context of health care delivery for American Indian and Alaska Native peoples are also discussed. [ABSTRACT FROM AUTHOR]

With more individuals with disabilities participating in interscholastic activities, it is important that athletic trainers (AT) understand how to best provide services for all athletes. Sixty-six program directors were surveyed using multiple-choice and open-ended questions to determine what course content related to people with disabilities is currently included in their AT preparation curriculum and what their opinions are related to including this content. Frequency counts and percentiles were calculated based on responses. Seventeen percent of the directors reported including a course on providing care for people with disabilities. Eighty-five programs included some content within a course, though only 55% of the programs cover more than three disabilities. Further findings and their implications are discussed. [ABSTRACT FROM AUTHOR]

The article focuses on the U.S. court case Hill v. Humphrey, which dealt with the reasonable doubt standard for mental retardation claims in criminal trials. Topics include the U.S. Antiterrorism and Effective Death Penalty Act of 1996 (AEDPA), the burden of proof requirements that must be met for mental retardation classification, and the constitutionality of imposing the death penalty on mentally retarded individuals.

Los Angeles County has the largest county welfare population in the United States. The county spends $23 million annually on mental health services for welfare participants. This study examines employment and treatment outcomes for welfare participants whose mental health services ended during a 1 year period. Factors associated with success are explored using detailed survey data from a subsample of 433 of these participants. Staff report that 70 percent of sample members have positive change in mental health status; however, only 17 percent of the clients complete treatment successfully, and only 26 percent report employment at discharge or in the 6 months after discharge. Analyses suggest that predictors of completing services successfully differ from predictors of employment. Further, successful completion of treatment does not predict employment. Some of these results are disappointing and have motivated county staff to restructure the menhttp://bkstrm.epnet.com:8080/ai/images/next.giftal health service offerings. [ABSTRACT FROM AUTHOR]

In one of its most controversial decisions to date, United States v. Comstock, the Roberts Court upheld a federal civil commitment statute requiring only an intermediate burden of proof. The statute provided for the postsentencing confinement of anyone proven by "clear and convincing evidence" to be mentally ill and dangerous. The law relied on a judicial standard established more than thirty years before. The majority in Comstock missed the opportunity to reassess the precedent in light of recent psychiatric studies indicating that the ambiguity of available diagnostic tools can lead to erroneous insanity assessments and mistaken evaluations about patients' likelihood to engage in dangerous activities. I contend that the "clear and convincing standard" of proof inadequately protects patients' due process rights because civil commitment hearings can result in severe deprivations of liberty. Commitments of felons whose continued dangerousness remains in doubt raises significant due process concerns. Even more troubling is the civil commitment of individuals with no criminal records of violence to whom the clear and convincing standard also applies. In this Article, I argue that the beyond a reasonable doubt standard of proof is needed to closely scrutinize evidence of mental disease and dangerousness. The multidisciplinary approach I pursue offers a unique framework for resolving a social problem that has been inadequately described in extant legal writings. I reflect on Supreme Court precedents in light of psychiatric studies about the limited reliability of emergency commitments and set out a standard adopted from criminal proceedings to better prevent unnecessary mental hospitalization [ABSTRACT FROM AUTHOR]

Objective. To compare the likelihood of intellectually and developmentally disabled (ID/DD) adults receiving a dental cleaning across places of residence. Data Sources. Medicaid and Minnesota's Medicaid Management Information System (MMIS) databases. Study Design. All adults with DD assessments in MMIS in 2001–2002. Data Extraction Methods. All completed DD assessments in 2001–2002 linked to Medicaid utilization data for same recipients for same years. Conclusions. The most disabled individuals are generally least likely to receive a dental cleaning. Individuals living in their own or a family home are less likely to receive the procedure than those living in ICF/MRs or a group home, even after controlling for disability, with those living in a group home falling in between ICF/MR and own/family home residents. The level of preventive dental care that ID/DD adults receive in community settings may be inadequate, particularly for persons living in own homes or with family. [ABSTRACT FROM AUTHOR]

A psychometric analysis was conducted to reduce the number of items needed to assess the disability associated with mental disorders using the World Health Organization Disability Assessment Schedule (WHODAS). The WHODAS was to be used in the Substance Abuse and Mental Health Services Administration National Survey on Drug Use and Health (NSDUH), beginning in 2008, as part of a screening algorithm to produce estimates of the prevalence of serious mental illness (SMI) in the US adult population. The goal of the work presented in this paper was to create a parsimonious screening scale from the full 16-item WHODAS that was administered to 24 156 respondents (aged 18?) in the 2002 NSDUH. Exploratory factor analysis showed that WHODAS responses were unidimensional. A two-parameter polytomous Item Response Theory model showed that all 16 WHODAS items had good item discrimination (slopes greater than 1.0) for each response option. Analysis of item difficulties and differential item function across socio-demographic categories was then used to select a subset of eight items to create a short version of the WHODAS. The Pearson correlation between scores in the original 16-item and reduced eight-item WHODAS scales was 0.97, documenting that the vast majority of variation in total scale scores was retained in the reduced scale. Copyright © 2010 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Casting a ballot is a primary form of community participation in the United States. This exercise provides citizens with a means to safeguard their legal rights and effectuate change. Nevertheless, some citizens, such as people with mental disabilities, are often denied this fundamental right solely based upon their status. These citizens have faced a long history of pernicious discrimination at the hands of their communities, legislators, and even the courts. Yet, social policy has begun to evolve in light of more nuanced understandings of mental disabilities. This knowledge has also spurred the reform of state and federal law. While the prospect of change looms high, in the context of voting, some states lag behind and recent jurisprudence demands that they reform voter eligibility requirements. This Note calls for all states to ensure that the right to vote is a presumptive right of the mentally disabled, to facilitate its exercise, and to deny it by a clear and fair standard that only excludes the mentally incapacitated when there is a clear lack of understanding of the nature and effect of voting. [ABSTRACT FROM AUTHOR]

The article discusses Missouri's Sexually Violent Predator (SVP) Law on sexual violence with mental unstability and the due process rights and safeguards of sexual violence cases amended in the U.S. Supreme Court. According to the SVP Law, the state is required to prove beyond reasonable doubt that an individual had committed sexual violent acts and possessed mental abnormality. Also discussed is the constitutional commitment against violent predators protecting members in the society.

A commonly-held belief is that locking up and forcibly drugging people diagnosed with mental illness is in their best interests as well as society's as a whole. The truth is far different. Rather than protecting the public from harm, public safety is decreased. Rather than helping psychiatric respondents, many are greatly harmed. The evidence on this is clear. Constitutional, statutory, and judge-made law, if followed, would protect psychiatric respondents from being erroneously deprived of their freedom and right to decline psychiatric drugs. However, lawyers representing psychiatric respondents, and judges hearing these cases uncritically reflect society's beliefs and do not engage in legitimate legal processes when conducting involuntarily commitment and forced drugging proceedings. By abandoning their core principle of zealous advocacy, lawyers representing psychiatric respondents interpose little, if any, defense and are not discovering and presenting to judges the evidence of the harm to their clients. By abandoning their core principle of being faithful to the law, judges have become instruments of oppression, rather than protectors of the rights of the downtrodden. While this Article focuses on Alaska, similar processes may be found in other United States' jurisdictions, with only the details differing. [ABSTRACT FROM AUTHOR]

Adult consumers with serious mental illness (SMI) die 25 years younger than other Americans. Considerable limitations are evident in existing data sets that inhibit our ability to fully disentangle the underlying excess mortality in these populations. To date, it has been necessary to use multiple surveys to examine these relationships as no available data sets combine high-quality data including psychiatric diagnosis, health risk behaviors, medical comorbidity, medical and mental service use, and quality of care. It is critical that medical and mental health surveys each move toward including more robust information on the corresponding comorbidities and use of services and that each begin to incorporate longitudinal designs. This article addresses the need for data on mortality, morbidity, and services. It discusses the availability of state mortality data, reviews the data provided by numerous national and state data collection instruments, and provides a case study of Maine's integrated data analysis efforts. Finally, our recommendations to improve these data are organized into two sections: proposed actions by the Substance Abuse and Mental Health Services Administration and proposed actions by other federal and state entities. [ABSTRACT FROM AUTHOR]

Consumers of mental health services die an average of 25 years earlier than the general public. Many of the health conditions that are associated with death in the United States and premature death in mental health consumers can be prevented and managed with positive health habits. The six most common causes of death are heart disease, cancer, stroke, lung conditions, accidents, and diabetes. We assert that many of the known risk factors for early death can be addressed with positive health habits. We discuss barriers to ideal health care, describe what is known about effective interventions for common risk factors, and, where information is available, what kinds of special interventions have been found to be effective for mental health consumers. We close with a set of recommendations based on three levels of interventions: those that can be readily implemented with little additional resource; those that require local leadership and some resources; and those that require national leadership to transform the current poor health status of many consumers in the United States. [ABSTRACT FROM AUTHOR]

Clinicians routinely ask people with disabling psychiatric illnesses whether they receive Supplemental Security Income (SSI) or Social Security Disability Insurance (DI) benefits. We looked at self-reported receipt of SSI or DI by 7,220 homeless people with mental illness and compared those self-reports with information in Social Security Administration (SSA) databases. Overall agreement between the two sources was only fair (kappa = 0.60), and 41.3 percent (934/2,257) of clients reporting receipt of SSI or DI were not in SSA's databases. In multivariate analyses, people reporting receipt of SSI or DI that is unconfirmed by SSA administrative records had disproportionately more severe psychotic and medical illnesses than confirmed nonrecipients. Among recipients identified by SSA, those who did not report receiving SSI or DI were more likely to claim, apparently incorrectly, that they instead received Social Security retirement benefits. Clinicians should verify basic demographic information provided by clients, especially those who are psychotic or medically ill, because that information is often inaccurate. [ABSTRACT FROM AUTHOR]

The article presents a research study that focuses on the relationship between self-determination of ethnic students with disabilities enrolled in special education classes and outcomes of transition from school to adulthood. Students who possess characteristics of self-determination, including skills in problem solving, decision making, and goal setting, are more likely to complete high school. The article provides examples of how parents, teachers, and schools can promote self-determination practices in learning disabled students of different ethnicities to reduce dropout rates, including allowing children to participate in the planning of family activities and implementing a curriculum that teaches self-determination.

The article discusses the law regarding the protection of unconscious, medically-dependent persons in the U.S. Information on the case of Karen Ann Quinlan, a young women considered profoundly mentally disabled and incompetent, is presented. The need for U.S. states to consider legislation that enhances the educational value of advance directives is mentioned. The common law on the right to self-determination regarding the refusal or acceptance of medical treatment is discussed.

The article discusses the plight of people with mental illness who are homeless in the U.S. The author describes how the society has become negligent of the predicament of the growing number of homeless and people with mental disabilities. Adding to the problem is the low priority given by many government, particularly in the U.S., to the sector. According to the U.S. Federal Task Force on Homelessness and Severe Mental Illness, approximately 150,000 to 200,000 persons with mental illness are living on the streets.

The article discusses the legal issues to consider in executing or imposing death penalty to mentally retarded offenders under the U.S. criminal justice system. The Supreme Court noted that the evolving standards of decency within the country prohibit the execution of people who are mentally retarded. The American Association of Mental Retardation defines the condition as substantial limitations in present functioning and characterized by significantly subaverage intellectual functioning. Psychology plays a significant role in the classification of intelligence.

Proposes a categorical exemption from capital punishment for individuals with severe mental disorders. Background on the Eight Amendment's mandate that capital punishment be commensurate with the character of the defendant and his or her criminal offense; Discussion of reduced moral culpability in capital defendants with mental retardation in the Supreme Court case Atkins v. Virginia; Information on state death penalty statute provisions that have a bearing on mental illness.

Provides a history of the establishment of the special education program for children with mental retardation in Indiana public schools from 1908 to 1931. Law requiring all public school districts in the state to establish special classes or courses to children with mental retardation; Categories of mental defect; Special class instruction conducted by Indiana's major city school districts between 1900 and 1930.

Focuses on the increase on the Medicaid litigation on behalf of the developmentally disabled in the U.S. Emergence of several categories of litigation; Improvement of institutional services for mentally retarded individuals; Provision of appropriate care.

Examines groups of women instrumental in the emergence of the category of feeblemindedness in the United States. Analysis on the dynamics of oppression and power relations; Concerns with the dangers of female feeblemindedness; Interpretations on the use of inmate labor from the perspective of institutional exigency.

Examines the legitimate needs of the mentally handicapped for adequate sex education in the United States. Misconceptions about sex education for the mentally handicapped; Assessment of need for sex education for the mentally handicapped; Teaching methods appropriate in effective sexual education.

People with psychiatric disabilities often need atypical accommodations to participate in today's workforce. Some of these accommodations, including structural and social changes in the workplace, can address biases against people with psychiatric disabilities, while others ameliorate deficits that may affect performance or interaction with others. Many courts have denied requests for such accommodations based on employers' assumptions about performance or the direct threats purportedly posed by people with psychiatric disabilities. By challenging these assumptions, which can be influenced by stigma and stereotypes, and by enforcing an employer's duty to interact regarding potential accommodations, employees with psychiatric disabilities could benefit from structural and social accommodations. Courts should consider social science research in determining which nontraditional accommodations may be reasonable and whether the employer can establish that they impose any undue hardship. Such consideration will expand opportunities for people with psychiatric disabilities in the workplace without unduly interfering with employers' interests. [ABSTRACT FROM AUTHOR]

Objective: To build and test a model that predicts community discharge probabilities for Medicaid-eligible nursing home (NH) residents who remain in the nursing home at 90 days after admission and, thus, would be candidates for the Money Follows the Person (MFP) program.Data Source: The Minimum Data Set, Medicaid Management Information Systems, and Minnesota Vital Statistics file.Data: Cohort of 33, 590 nursing home stays that qualified for Medicaid by the 90th day of their stay from 383 Minnesota nursing homes from July 2011 to June 2013.Study Design: Mixed effects logistic regression model to predict community discharge.Principal Findings: The scoring system had a high level of accuracy in predicting community discharge for both the fitting and validation cohorts. Subpopulations with severe mental illness or intellectual disability were well represented across the entire score range.Conclusions: Findings are being applied in the Minnesota's MFP initiative (Moving Home Minnesota) to target Medicaid-eligible NH residents for transitioning to the community. This approach could be applied to MFP in other states. [ABSTRACT FROM AUTHOR]