Outpatient mental health services for persons with mental retardation and psychiatric disorders: Assessment of CMHC clinicians' knowledge and attitudes

Stephen Schmidt (1992)

One hundred and twelve Community Mental Health Center clinicians in the State of New Hampshire were surveyed to explore knowledge about the psychiatric aspects of mental retardation and attitudes toward mental health care for the retarded. Clinicians showed relatively poor knowledge but largely positive attitudes toward the retarded. Several Knowledge and Attitude Factors emerged from principal components analyses. The Knowledge Factor that involved general information about mental retardation in general and the incidence and types of psychopathology experienced by the retarded proved to be a significant discriminator of clinician knowledge. Clinicians who scored highest on this Factor also held the most positive attitudes toward the retarded. Males scored higher for this Factor than females, owing to greater information about mental retardation in general. Clinicians who had more experience with mentally retarded patients held more positive attitudes toward the retarded than less experienced clinicians. No relationship was found between attitudes toward the mentally retarded and clinicians' preferences for working with other potentially "undesirable" patients. Clinicians were found to hold substantial misinformation about the retarded and about the psychiatric dimensions of retardation. They were likely to equate mental retardation with the kind of features characteristic at the moderate and severe ranges of retardation, rather than features characteristic of mild retardation--the level where the greatest number of mentally retarded individuals function. Clinicians were likely to underestimate the capacity of mentally retarded persons to communicate and be able to function independently. They believed inaccurately that the symptomatology of some common psychiatric disorders differed substantially in the retarded compared to nonretarded persons. Clinicians were also likely to underestimate the ability of the retarded to benefit from psychotherapy. The findings of this research did not support previous suggestions that clinicians' negative attitudes toward the retarded exclude mentally retarded individuals from mental health treatment. These findings were congruent with observations that clinicians have poor and often inaccurate knowledge of the mental health aspects of mental retardation. Findings support suggestions that mental health clinicians need and can benefit from information and training about the psychiatric aspects of retardation.