The care of individuals with mental retardation: lessons from the New Zealand experience

The care of individuals with mental retardation has changed with broad and growing acceptance of their place within the community. Data from a national study in New Zealand illustrates the influence of global trends in care, and the continuing need for advocacy ill addition to clinical care. Effects of changing patterns of care on families and on agencies have been mixed as a result of the mismatch among political philosophies, demographic and social trends, and community changes. Support for families that care and for self advocacy are essential parts of the care system. Effective care depends on good communication and personal knowledge between the provider of care and the person with mental retardation. Sexual health and women's health issues are areas where good communication between the physician and patient are particularly important. Areas of continuing health care need are screening for hearing and visual problems, gastrointestinal disorders, dementia and depression, and review of medications. Involvement in fitness programs, recreational and social activities, and paid work are also identified as enhancing health. Support for self advocates and their families, and where necessary advocacy directed at improving the social environments and the standards of care available to individuals with mental retardation, are an integral part of the work of physicians caring for this population.