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5 - Mentally ill or cognitively impaired patients

Published online by Cambridge University Press:  17 August 2009

Fiona E. Gallahue  and
Laura D. Melville
By
Stephanie Cooper M.D.
Fiona E. Gallahue
Affiliation:
Weill Medical College of Cornell University
Laura D. Melville
Affiliation:
Weill Medical College of Cornell University
Stephanie Cooper M.D.
Affiliation:
Clinical Attending Harborview Medical Center
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Summary

Goals and objectives

  1. To understand the increased risk of abuse that faces mentally ill and intellectually disabled (ID) people

  2. To learn to identify, manage, and refer patients who are mentally ill or intellectually disabled who have been abused

Abuse of mentally ill and intellectually disabled people

Overview

Mentally ill and intellectually disabled people are among the vulnerable populations more likely to be victimized and abused. Obstacles to reporting abuse within these disenfranchised groups have made this problem more difficult to chronicle, treat, and prevent. This chapter will provide an overview of the prevalence of abuse, the types of abuse, and strategies for better reporting and preventing abuse within the psychosocially vulnerable cohorts of mentally ill and intellectually disabled patients.

Abuse is a public health issue. Maltreatment can lead to physical trauma, emotional trauma, and even death. Mentally ill patients are prone to worsening of their psychiatric condition after being abused. Intellectually disabled patients may suffer worsening of their primary disability, or, they may develop secondary disabilities resulting from the victimization. In both populations, physical, sexual, and emotional abuse aggravates the pre-existing condition, requiring additional health interventions and both medical and psychological assistance.

Abuse of the intellectually disabled

Definition of intellectually disabled

Intellectually disabled (ID) people are defined as individuals who have unique needs with regards to information processing. Intellectual disability can be congenital or acquired through accident or disease. The disability can affect memory, learning, speaking, problem solving, and other cognitive skills.

Type
Chapter
Information
Emergency Care of the Abused , pp. 150 - 168
Publisher: Cambridge University Press
Print publication year: 2008

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References

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Stuart, H. Violence and mental illness: an overview. World Psychiatry. 2003 June; 2(2): 121–4.Google ScholarPubMed
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Burke, L, Bedard, C. Self-injury considered in association with sexual victimization in individuals with a developmental handicap. Canadian Journal of Human Sexuality. Fall 1994; 3(3): 253– 62.Google Scholar
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Horner-Johnson, W, Drum, C. Prevalence of maltreatment of people with intellectual disabilities: A review of recently published research. Mental Retardation and Developmental Disabilities Research Reviews. 2006; 12: 57–69.CrossRefGoogle ScholarPubMed
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Muccigrosso, L. Sexual abuse prevention strategies and programs for persons with developmental disabilities. Sexuality and Disability. Fall 1991; 9(3): 261–71.CrossRefGoogle Scholar
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Oktay, J S, Tompkins, C J. Personal assistance providers' mistreatment of disabled adults. Health Social Work. Aug 2004; 29(3): 177–87.CrossRefGoogle ScholarPubMed
Peckham, N, Howlett, S, Corbett, A. 2007. Evaluating a survivor's group pilot for women with significant intellectual disabilities who have been sexually abused. Journal of Applied Research in Intellectual Disabilities. Jul 2007; 20(4): 308–22.CrossRefGoogle Scholar
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Pillemer, K, Suitor, J. Violence and violent feelings: what causes them among family caregivers?J Gerontol. 1992; 47(4): S165–S172.CrossRefGoogle ScholarPubMed
Powers, L E, Curry, M A, Oschwald, M, et al. Barriers and strategies in addressing abuse: A survey of disabled women's experiencesJ Rehabil. 2002; 68: 4–13.Google Scholar
Sequera, H, Howlin, P, Hollins, S. Psychological disturbance associated with sexual abuse in people with learning disabilities: case-control study. British Journal of Psychiatry. Nov 2003; 183(5): 451–6.CrossRefGoogle Scholar
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