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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.

Background For most people, choice making is an everyday occurrence, but for adults with an intellectual disability (ID), such opportunities are often limited, if not, absent. Defining choice, and related opportunity capacity and supports continue to feature prominently in academic, practice and policy discourse within the field of ID as reflected in the range of measures available. This paper examines the factor analytic properties of an adapted 14-item choice inventory scale. Method Presence and type of choice were recorded in wave 1 of the Intellectual Disability Supplement to the Irish Longitudinal Study on Ageing using a choice inventory scale adapted for the Irish context for 753 participants with ID over age 40 years. Analysis included both an exploratory and confirmatory factor analysis. Descriptive statistics on choice by type of living arrangement, type of interview (proxy, self or supported) and level of ID are presented. Results Exploratory factor analysis indicates good model fit when using both a 3-item and 4-item response with the 4-item version suggesting a two-factor model. Further exploration of this two-factor model through confirmatory factor analysis highlighted an improved fit for the 4-item model. Further improvement in model fit is found when four item pairs are co-varied within the model. Conclusion Two broad types of choice were found to exist for adults with ID - everyday decisions and key life decisions. In addition, the factor analysis support for the inclusion of a 'no choice' response may help reduce the potential for missing data. [ABSTRACT FROM AUTHOR]

The paradigm shift in mental health opens the door to a multidisciplinary approach. We advocate the need to invest in the recovery of people with Severe Mental Disorder from a socio-educational perspective, beyond the classic medical-clinical approach. The literature is reviewed and the results of various programs to support housing as a centerpiece of community intervention are analyzed. Improved personal and social functioning, fewer revenues, greater satisfaction and quality of life at lower cost is evidence. It is therefore crucial setting public policy of social action that promotes the conditions necessary to achieve social justice and inclusive citizenship. The relevance of Social Pedagogy and Social Education in achieving this goal and in improving their quality of life is concluded. We demand their theoretical and practical space in the field of mental health. [ABSTRACT FROM AUTHOR]

Objective: Growing recognition exists of housing as a social determinant of health, and thus, health care reform initiatives are expanding the reach of health care beyond traditional settings. One result of this expansion is increased Medicaid funds for supportive-housing programs for people with severe mental illnesses. This qualitative study explores the ways in which case managers working in a supportive housing program approach treatment and how their approach is influenced by both program requirements and their beliefs about mental illness. Method: The study is part of a longitudinal qualitative study on recovery for people with severe mental illnesses living in supportive housing. Multiple interviews (n = 55) with 24 case managers from a residential-continuum supportive-housing program were conducted over 18 months. To provide an indepth view of case manager perspectives, the study uses thematic analysis with multiple coders. Results: Overall, case managers understand supportive housing as being a treatment program but predominantly characterize treatment as medication management. The following themes emerged: believing medication to be the key to success in the program, persuading residents to take medication, and questioning the utility of the program for residents who were not medication adherent. Conclusions: Case managers understand supportive housing to be a treatment program; however, given the external constraints and their own beliefs about mental illness, case managers often equate treatment with taking medication. Study findings demonstrate the need to train case managers about mental health recovery and integrated health care. The findings also have implications for policies that tie housing to services. [ABSTRACT FROM AUTHOR]

Purpose: Mental ill health in adults with intellectual disability (ID) is a neglected field in psychiatry and thus still widely understudied. This paper provides data on the prevalence of mental illness and problem behaviour and analyses support needs, mental health service use and psychotropic medication in a representative sample of adults with mild to moderate ID.Methods: A set of well-established instruments was used to assess the main parameters in n = 371 participants recruited within a cross-sectional epidemiological multicentre study using a stratified randomised cluster sampling.Results: Point prevalence of mental disorders was 10.8 %, that of problem behaviour 45.3 %. Most study participants needed help in specific lower order need areas (e.g., money budgeting, food, accommodation), and these need areas were mostly rated as met. The highest ratios of unmet to met need were found with respect to sexuality issues and with respect to mental health problems. The focus of psychiatric treatment was psychotropic medication.Conclusions: Referring to ICD-10 based diagnostic criteria and consequently avoiding confusing problem behaviour with mental disorders, point prevalence of mental disorders was lower than in the general population. A systematic deficit in meeting mental health problems in adults with ID indicates the need for implementing strategies to maximise the quality of identification and management of mental disorders. [ABSTRACT FROM AUTHOR]

Supported housing programmes for people with chronic mental health needs have shifted towards approaches that rely on housing first, which prioritizes access to a permanent home in the community. How do support programmes with this assumption manage the market constraints of a shortage of affordable housing? The article examines empirical mixed method data (interviews and programme data) about the experience of managing this problem in the Mental Health Housing and Accommodation Support Initiative ( HASI) in New South Wales, Australia. HASI provides clinical mental health services, housing support and housing if needed, for people who are not yet living independently in the community. It found that the housing shortage affected the ability of the providers to implement the intended programme design at three early steps in the support: determining eligibility; prioritizing access between people with and without housing; and managing entry to the programme when they did not have housing. As a result, some otherwise suitable applicants were not prioritized for entry into the programme or their entry was delayed until they were housed. The providers adjusted the programme to the housing market realities, which compromised the programme intentions. The policy lessons are that programmes need strategies to provide housing for people who require it; assist people to find or apply for housing; and support people while they wait for housing. These approaches enhance the coherence of programmes, build on integration mechanisms and respond to the housing context. [ABSTRACT FROM AUTHOR]

In Canada, Review Boards are mandated to evaluate individuals found Not Criminally Responsible on Account of Mental Disorder (NCRMD) on an annual basis and render 1 of 3 dispositions: (a) custody, (b) conditional discharge, or (c) absolute discharge. To promote social reintegration, conditional discharge can be ordered with the condition to live in supportive housing. However, NCRMD accused face great barriers to housing access as a result of the stigma associated with the forensic label. The goal of this study was to evaluate the role of housing in the clinical and criminal trajectories of forensic patients as they reintegrate into the community. Data for this study were extracted from a national study of individuals found NCRMD in Canada (Crocker, Nicholls, Seto, Cote, et al., in press). The present study focuses on a random sample of NCRMD accused in the province of Quebec, who were under a conditional discharge disposition during the study period (n = 837). Controlling for sociodemographic, clinical, and criminal variables, survival analysis showed that individuals placed in independent housing following a conditional discharge from the Review Board were 2.5 times more likely to commit a new offense, nearly 3 times more likely to commit an offense against a person, and 1.4 times more likely to be readmitted for psychiatric treatment compared with individuals residing in supportive housing. These results point to the influence housing can have on the trajectories of forensic patients, above and beyond a range of clinical, criminological, and sociodemographic factors. [ABSTRACT FROM AUTHOR]

Objective: California's full-service partnerships (FSPs) provide a combination of subsidized permanent housing and multidisciplinary teambased services with a focus on rehabilitation and recovery. The goal of the study was to examine whether participation in FSPs is associated with changes in health service use and costs compared with usual care. Methods: A quasi-experimental, pre-post, intent-to-treat design with a propensity score-matched contemporaneous control group was used to compare health service use and costs among 10,231 FSP clients and 10,231 matched clients with serious mental illness who were receiving public m ental health services in California from January 1,2004 , through June 30, 2010. Results: Among FSP participants, the mean annual number of mental health outpatient visits increased by 55.5, and annual mental health costs increased by $11,725 relative to the matched control group. Total service costs increased by $12,056. Conclusions: Participation in an FSP was associated with increases in outpatient visits and their associated costs. As supportive housing programs are implemented nationally and on a large scale, these programs will likely need to be more effectively designed and targeted in order to achieve reductions in costly inpatient services. [ABSTRACT FROM AUTHOR]

Highlights: [•] A diet and physical activity intervention in community residences. [•] The 3-component intervention targeted both caregivers and residents. [•] The study design was a cluster RCT in 30 residences. [•] A significant intervention effect was found on physical activity and work routines. [•] The type of residence was found to be an effect moderator for physical activity. [Copyright &y& Elsevier]

This article describes a risk audit carried out on the support provided for 36 people with profound learning disabilities who had been resettled from hospital care to supported housing. The risks were those factors identified in the literature as associated with deleterious effects on quality of life. The audit was carried out with a specially designed tool that covered 24 possible risks and involved a support worker familiar with the service user choosing the most appropriate statement regarding each risk. Their judgements were verified by care managers and social needs assessors. Whilst one or more risks were identified for 32 of the 36 service users, the overall result showed relatively low risks for the group as a whole with 62 incidences (7%) from a possible 864, which nevertheless highlighted several areas that needed attention. The results of the audit have led to action plans for the provision and for the individual service users for whom risks were identified. [ABSTRACT FROM AUTHOR]

Today, many state-licensed group homes for mentally disabled adults have come to resemble their predecessor psychiatric institutions in that they segregate residents from the community at large. In 2010, a court found that private group homes in New York discriminated against the mentally disabled in violation of the Americans with Disabilities Act (ADA). The court ordered the state to establish non-discriminatory housing alternatives where residents could live, and become part of, the community at large. This groundbreaking litigation has prompted similar efforts in other states. In addition to the ADA, the Fair Housing Act (FHA) also protects the mentally disabled from discrimination arising from segregated housing. This Note examines whether the FHA supports a discrimination claim on behalf of the mentally disabled residing in segregated group homes. The differences between the ADA and FHA approaches are analyzed in terms of standing, defenses, and remedies, in order to determine whether a FHA claim increases the chances of successful litigation, in turn furthering the underlying policy goal of ending discrimination in housing. [ABSTRACT FROM AUTHOR]

The article looks at the drawbacks of the U.S. Supreme Court's decision on the case involving the Cleburne, Texas and Cleburne Living Center Inc. It explains that the Court's decision to invalidate a zoning ordinance that discriminated mentally retarded persons was criticized by legal experts since the Court never applied the Equal Protection Clause for invalidation. It also notes that the focus on remedial legislative actions was risky since these reforms could be short-lived and misapplied.

The article focuses on the enforcement of residential services for people with intellectual and developmental disabilities on the Year of Community Living launched by President Barack Obama in June 2009. It says that the Year of Community Living begins on Olmstead's 10th anniversary and ends on the 20th anniversary of Americans With Disabilities Act (ADA). It presents several charts which compare the total number of persons with disabilities who received residential services from 1988 to 2008.

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Abstract: Housing and services for persons with developmental disabilities (DD) have been shaped by the normalization approach, a commitment to full integration within the general community. In contrast, housing and services for persons with psychiatric disabilities (PD) have had various and sometimes conflicting goals, including provision of custodial care, promotion of therapeutic community, and community integration. This cross-field study compares the neighborhood characteristics of publicly-funded housing for the PD and DD populations in a metropolitan community. The aim of the study was to examine whether the contrasting housing approaches are reflected at an ecological level and to consider how these findings relate to the goal of community integration for people with PD and DD. Administrative databases provided residential addresses of 1932 residents with PD living in 297 locations and 1716 residents with DD living in 749 locations in the city of Philadelphia. The 2000 U.S. Census and city''s police department database provided information on neighborhood characteristics. Geographic information system (GIS) methodology generated maps displaying the distribution of housing locations in relation to spatial dispersion, distress, stability, safety, and race/ethnic diversity. Statistical analyses compared neighborhood characteristics of the DD and PD populations. Findings indicated that the DD population in supportive housing was more spatially dispersed, and lived in less distressed, less unstable, more secure, but equally racially/ethnically diverse neighborhoods when compared to the PD population in supportive housing. Greater geographic dispersal among persons with DD may be the result of more emphasis on normalization within policies and programs determining the location of their housing. The higher funding levels for housing and residential support for persons with DD also provided programs with the option of placing people in higher income neighborhoods. Given that community integration has emerged as an organizing principle within mental health services over other models, policymakers in the field of psychiatric disabilities may have much to learn from the normalization movement for people with developmental disabilities. [Copyright &y& Elsevier]

The rigid linear model of community mental health care in specialist temporary accommodation in Rome failed to deliver the progress in service user outcomes. A radical review and co-production exercise by staff, service users and relatives commissioned a flexible recovery-based model that better met the needs of people in Rome. [ABSTRACT FROM AUTHOR]

The new local government performance framework, in combination with the move towards greater personalisation in services, creates a radically new funding environment for housing with care and support. From the Public Service Agreement (PSA) on achieving settled accommodation for individuals at risk of exclusion, through to the impact of local joint strategic needs asessments and individual budgets, the principles and mechanisms of the new joint commissioning culture create more opportunities for providers to articulate the needs of the client group served, and to assert the case for more joined-up and responsive services. This may require different skills and new styles of leadership at local level, and providers who have become adept at being competitors may need to re-discover the skills of partnership. Meanwhile, new social exclusion policy frameworks are emerging for supported accommodation, which can support moves away from institutional care for those with mental health problems. [ABSTRACT FROM AUTHOR]

The article discusses the four basic residential options where people with intellectual and development disabilities (ID/DD) live while receiving services and support from state-managed developmental disabilities programs, from June 30, 1996 to June 30, 2006 in U.S. These include congregate care, host family/foster care, own home and family home. A table showing the total number of persons with ID/IDD receiving services and support from state programs as well as a breakdown of service recipients with ID/IDD, by number and percentage, living in various residential circumstances is presented.

Background: During the past two decades, consumers, providers and policy makers have recognized the role of supported housing intervention for persons diagnosed with serious mental illness (SMI) to be able to live independently in the community. Much of supported housing research to date, however, has been conducted in large urban centers rather than northern and rural communities. Northern conditional and contextual issues such as rural poverty, lack of accessible mental health services, small or non-existing housing markets, lack of a continuum of support or housing services, and in some communities, a poor quality of housing challenge the viability of effective supported housing services. The current research proposal aims to describe and evaluate the processes and outcomes of supported housing programs for persons living with SMI in northern and rural communities from the perspective of clients, their families, and community providers. Methods: This research will use a mixed method design guided by participatory action research. The study will be conducted over two years, in four stages. Stage I will involve setting up the research in each of the four northern sites. In Stage II a descriptive cross-sectional survey will be used to obtain information about the three client outcomes: housing history, quality of life and housing preference. In Stage III two participatory action strategies, focus groups and photo-voice, will be used to explore perceptions of supported housing services. In the last stage findings from the study will be re-presented to the participants, as well as other key community individuals in order to translate them into policy. Conclusion: Supported housing intervention is a core feature of mental health care, and it requires evaluation. The lack of research in northern and rural SMI populations heightens the relevance of research findings for health service planning. The inclusion of multiple stakeholder groups, using a variety of data collection approaches, contributes to a comprehensive, systems-level examination of supported housing in smaller communities. It is anticipated that the study's findings will not only have utility across Ontario, but also Canada. [ABSTRACT FROM AUTHOR]

Adults with ID/DD live in increasingly small community settings, where the risk of loneliness may be greater. We examined self-reported loneliness among 1,002 individuals with ID/DD from 5 states in relation to community residence size, personal characteristics, social contact, and social climate. One third reported being lonely sometimes and one sixth said they were often lonely, but loneliness was not more common for people living alone or in very small settings. More loneliness was reported by residents of larger community living settings of 7 to 15 people. More social contact and liking where one lives were associated with less loneliness. Social climate variables, such as being afraid at home or in one's local community, were strongly associated with greater loneliness. [ABSTRACT FROM AUTHOR]

Evidence from a variety of sources indicates that there is a correlation between environment, support structures and behavioural response for people with complex needs which affects the quality of life in living environments. As part of the shift from institutional living to community-based options, an inclusive approach, working on a theoretical and practice-based response, was established. The aim of the project was to achieve an inclusive package of support while encouraging development of individual skills of daily living, in a flexible and interactive environment. During the course of the project, 39 purpose-built housing units were established using the approach described, and they are currently the subject of evaluation. [ABSTRACT FROM AUTHOR]

In residential homes for people with learning or intellectual disabilities (or mental retardation, in North American usage), a routine way for staff members to structure residents' time is to propose outside activities (e.g. shopping trips to town, attendance at a concert and so on). We identify one common way of proposing such activities that reveals a subtle but significant aspect of the staff's understanding of the residents' identities. Staff often introduce an activity not by mentioning its actual qualities (e.g. ‘Do you want to go and see a church concert with lots of singing?’), but by associating it with a given individual (e.g. ‘Do you want to go to a concert with Bill?’). This practice favours the social aspect of the residents' choices over any other, and encourages the residents' conceptions of themselves as people with feelings who care about others, and who are, in turn, cared about. We discuss the implications of such an apparently positive identity ascription. [ABSTRACT FROM AUTHOR]

This paper discusses issues in the development of collaborative efforts among stakeholders in a community housing and support system dedicated to people with serious mental illness. Whereas community development efforts directed at localities are more common, the increasing recognition of the system-level barriers facing marginalized groups requires community development efforts that are relevant to communities of stakeholders in service systems. The paper draws on work conducted by the authors to understand, to evaluate, and to support the development of a system of housing dedicated to people with serious mental illness in Ontario. Although these projects were not intended as community development, they have uncovered issues that are likely to arise in a community development effort in this context. [ABSTRACT FROM AUTHOR]

Objective: Homelessness among people with a mental illness is a serious issue. Objective: The study aimed to identify the types of housing available for people with a mental illness in the region; to develop an audit tool to assess the housing of patients of the mental health service; and to pilot this audit tool. Method: Key informants were interviewed to obtain information about the type of housing options available in the Loddon Campaspe Southern Mallee Region. This information was used to develop a survey to audit the housing status of existing patients of the area mental health service. A pilot study using the survey was completed by case managers for 81 patients who were being case managed by the area mental health service. Results: There were a wide variety of housing options in the region, but housing availability was not evenly distributed. Although most patients lived in owned or rented accommodation, a substantial proportion of patients had difficulties with accessing the required services, the affordability of their housing, uncertainty of tenure or were at risk of violence within their housing. Conclusions: A substantial proportion of patients treated by a rural area mental health service had lived in impoverished housing. [ABSTRACT FROM AUTHOR]

This article reports the main health status differences between a representative sample of homeless people and an at-risk for homelessness group consisting of people who use services for the homeless such as soup kitchens and public baths but have and maintain a home. The variables analyzed include health problems by system, risk habits and behaviors, substance use, alcohol problems, general health status, suicidal thoughts and perceived health status. Because of the gender differences between groups, the data were analyzed independently for men and women. The results show that the homeless have worse health status compared with the at-risk group. Homeless men had significantly more risk habits and behaviors, substance use, and mental health problems. Homeless women had similar tendencies, although they also had significantly more general health illnesses (by systems and over the past year). Almost no differences were found in drug use (especially alcohol use) or in mental health—except for depression, which was significant. These results shed light on new data regarding the correlation between homelessness and health issues. [ABSTRACT FROM AUTHOR]

This article introduces new initiatives in homelessness legislation, in funding resettlement support, and in health services for different homeless populations (i.e., single, youth, and family homeless) and discusses the different rates of mental illness among these populations in Great Britain. It reviews studies that indicate the strong role played by permanent resettlement in reducing rates of neurosis among all three homeless populations. Finally, it considers the incidence of violent life events among different homeless populations and suggests a further approach to the investigation of violent life events. [ABSTRACT FROM AUTHOR]

This article describes a shared ownership scheme developed by Advance Housing and Support so that people who have experienced mental health difficulties could have the choice to own their own home. Jennifer Barrett, Hilary Caldicott and Trevor Sasar De Sain have all been involved in Own Home - one as the project manager and the other two as shared owners with the scheme - and here describe what it was like from the inside, what worked and what didn't, and the impact of housing on people's experience of social exclusion and the accompanying loss of hope. [ABSTRACT FROM AUTHOR]

The Social Exclusion Unit's report on mental health, published in the summer of 2004, had surprisingly little to say about housing. But behind the scenes there has been a ferment of activity, and the National Institute for Mental Health for England (NIMHE) has been given the lead role in advancing all central government efforts to create a more joined-up vision of mental health for the 21st century. NIMHE has taken the lead on implementation of the SEU's conclusions, and much more besides. A National Project Team on mental health and housing is to come together next year, with a wide-ranging brief. This article looks at some of the issues that this new body will take on, including a new focus on research on the links between poor mental health and poor housing, and on evaluation of 'housing-based solutions'. As NIMHE itself is absorbed from April into the new Care Services Improvement Partnership, the prospects for linking housing with the community care modernisation agenda must be looking up. [ABSTRACT FROM AUTHOR]

Although persons with serious mental illness experience significant unmet housing needs, basic information on how housing is successfully financed, developed, and operated for them is lacking. It is possible that standard housing rules of thumb may not apply to this population. (For example, community opposition may raise development costs.) This lack of information may be a stumbling block to policy makers, planners, and developers. This article attempts to close the gap by examining the financial profile of 153 properties developed for persons with serious mental illness by five nonprofit housing corporations between 1988 and 1992. Our analysis suggests that although this housing may require more management attention, it is not fundamentally different from market-rate housing for low-income tenants. After more than 10 years, the nonprofit housing developers continue to thrive, and virtually all of the properties continue to serve persons with mental illness, demonstrating that such housing can be successfully developed and operated. [ABSTRACT FROM AUTHOR]

Objective: To discuss issues relevant to the equitable delivery of public housing services to people with mental illness. Strategies adopted by Queensland Department of Housing to address these issues and to improve services are described, and matters of particular relevance to mental health professionals are highlighted. Conclusions: Formal interagency service agreements between the Departments of Health, Housing and Disability Services, appropriate training programs, and case conferencing strategies can enhance the delivery of appropriate housing services to people with mental illness. Promotion of active interagency collaboration by mental health professionals will facilitate these strategies. [ABSTRACT FROM AUTHOR]

Examines family involvement with mentally retarded adults following residential transition to a nonparental living. Emotional involvement of mothers after the relocation; Change in mentally retarded adults' relationship with their siblings; Steps involved in mentally retarded adults' transition from parental homes to nonparental living.

Examines the residential accommodation of groups with intellectual disabilities (ID) in relation to National Health Service and Community Care Act, 1990 in Great Britain. Decision making process of the benefit group (BG) and resource groups (RG) in residential accommodations; Data on service utilization and costs; Usefulness of BG and RG in the context of ID services.

Focuses on the community-based residential facilities for people with intellectual disabilities (ID) in Israel. Focus on the multidimensional perspective of the residential facilities; Analysis of neighborhood acceptance by interactions between facility variables and neighborhood population; Interventions of the community integration of people with ID.

This paper uses recent developments in services in the UK as a case study to identify some of the challenges facing the provision of residential supports to people with intellectual disabilities. Three main areas are discussed: (1) responding to existing levels of unmet need and increasing levels of demand; (2) reducing inequalities in access to and the quality of services; and (3) obtaining and demonstrating "best value". In particular, discussion is focused on the relationships between needs, resources, process and outcomes in residential services for people with intellectual disabilities and the implications of these relationships for obtaining "best value". [ABSTRACT FROM AUTHOR]

Describes an evaluation study of a volunteer monitoring program in mental institutions in Michigan. Improvement of the quality of life in group homes for adults with mental retardation; Development of valid measures and design; Testing of the impact of the program; Association of frequent monitoring with the improvements in the homes.

Studies the future residential plans and placement preferences of mothers of mentally retarded adult children living at home. Background characteristics; Maternal psychological well-being; Support systems.

Examines the residential settings and opportunities for choice of adults with mental retardation. Analysis of staff presence and living-unit size; Effects of staff presence; Staff presence and living-unit size as important predictors of choice.

Changes in roles and responsibilities brought about by community care and the reorganization of the UK National Health Service (NHS) have resulted in higher levels of stress and insecurity amongst residential nursing staff working with people with intellectual disability. In the light of these organizational changes, questions have arisen about the relationship between role clarity, perception of the organization and occupational stress. A number of studies have investigated these issues amongst staff working with people with intellectual disability, although there have been few investigations in the UK. The present study examines the relationship between these variables in the context of the differences between the employees of an NHS trust and a charitable organization. The present study involved constructing a measure of role clarity and perception of the organization, and the use of the Maslach Burnout Inventory (MBI). The results indicated that most support workers regarded their role as being clear and their levels of burnout to be comparable with UK nursing norms. Charity staff were more likely to view their organization positively and rated their emotional exhaustion as significantly lower than NHS trust staff. A within-service comparison of homes revealed differences amongst NHS trust and charity homes on sub-scales of the MBI. The results are discussed in the context of previous research and changes in working practices in the field. [ABSTRACT FROM AUTHOR]

A total population study of people in Wales with severe intellectual disability and the most severe challenging behaviour was undertaken to identify their characteristics, and the nature of their residential arrangements and service support. Forty-one participants were identified: five living in family homes, 17 in community housing, 17 in hospitals and two in hostels. The family home group had slightly higher adaptive behaviour scores than residents in community housing. Both groups had significantly higher scores than the hospital and hostel residents combined. Assessments of challenging behaviour showed the groups to be similar and to have a considerable range and extent of severely problematic behaviour. Co-occurrence of several forms of frequent severe problem behaviour was the norm and there was a marked association with social impairment. The five people living in their family homes had nominated service keyworkers, but reported professional input was low. The residential situations comprised two main service types: (1) traditional services, which were characterized by large living unit and facility size, atypical architectural design, relative isolation from the community, a greater level of buildings adaptations, low staff:resident ratios, a relatively high percentage of qualified staff, and a relative absence of systematic approaches to goal planning and structured activity; and (2) new community houses, which were characterized by small size, domestic design, location within the community, a lower level of buildings adaptations, much higher staff:resident ratios, and less emphasis on qualified staff but a greater emphasis on systematic working methods. Community settings were similar in having ‘specialist’ resident groupings based on challenging behaviour or conditions like autism in which challenging behaviours are common. A policy to provide for people with these characteristics being resettled from traditional settings in this way... [ABSTRACT FROM AUTHOR]

The article discusses several factors to be considered in the placement of institutionalized mentally retarded persons in group homes. Review teams tend to place higher functioning residents in less restrictive settings. Upon analysis, it was discovered that the placement recommendations from institutional review teams were influenced by the characteristics and needs of the residents. Usually, the highest functioning persons were recommended for group home placements.

The article discusses a 1977 U.S. mail survey of all community residential facilities (CRF) for mentally deficient people that was conducted by the Developmental Disabilities Project on Residential Services and Community Adjustment at the University of Minnesota. The effect of the deinstitutionalization movement for mentally deficient people was verified by the survey results. Findings shows that the number of CRFs doubled between 1973 and 1977. The results also confirm two trends, namely, variations in facility size and the degree to which states utilize community living arrangements to serve the mentally retarded.

The article examines the effects to institutionalized retarded residents of the relocation from an older, crowded living unit to a modern, uncrowded unit. Weight change and the initiation and duration of constructive and nonconstructive behavior were examined. Prolonged overcrowding and relocation affect the social interactions of residents and staff. Although relocation caused significant changes in a variety of behaviors, not all were deleterious.

The research investigates the effects of dwellings occupied exclusively by severely mentally disabled (SMD) tenants on sales prices of nearby homes. Hedonic price models are estimated for an exhaustive sample of single-family home sales from 1989 to first quarter 1992 in Newark and Mt. Vernon, OH. Proximity within two blocks of rehabilitated dwellings occupied by SMD had no significant relationship with sales prices. Prices of homes proximate to two small, newly constructed apartment complexes were 40% lower after the complexes opened, although those near three other similar apartment complexes were not. [ABSTRACT FROM AUTHOR]

This paper examines the capital costs and accommodation provided in three different types of residential facility for mentally handicapped people--a large campus hospital, a small campus hospital and a network of individually-sited hospital units. The findings do not indicate any economy arising from increased size, or from centralization of facilities on a single site. These findings, together with the other research cited, have implications for the design of future residential services. [ABSTRACT FROM AUTHOR]

The Americans with Disahilities Act (ADA) was enacted with the hope that it would result in the end of segregation based on disability. That promise has been only partially met. However, two recent settlement agreements between the U.S. Department of Justice and the states of New York and Rhode Island promise sweeping change in housing and employment for thousands of individuals with mental disabilities. This column describes the agreements, which adopt best practices as the foundation for community change and which suggest that the ADA may be reaching its full promise. [ABSTRACT FROM AUTHOR]

The article discusses the significant aspects in the planning and development of institutional care plants with particular reference to the institutions for the mentally retarded. It is important that an outline of the principles and philosophy must be made to guide and an outline for its planning and forecasting, which will give a thought on the process to be employed for the effective development of the program and creation of its plant to house the program. Some factors to be considered are the technical advisor and staff, selection of site and overall construction of the project.