Are the medical needs of mentally handicapped adults being met?

This paper reports on the apparent inadequate level of primary medical care provided to many of the 151 mentally handicapped people who attend an adult training centre. A large number of common medical problems were identified that were not known to the general practitioners and/or were not being managed, including problems known to be associated with Down's syndrome. Many trainees were further handicapped by unmanaged defects of hearing and vision. Contact rates with the general practitioner showed that the mentally handicapped adults did not place a greater burden on the doctor than the rest of the population. Comparing these rates with those for other vulnerable groups such as those aged over 75 years and under four years showed that only 28% of the trainees had an adequate consultation rate with the general practitioner.A lack of awareness among general practitioners of the special needs of this group is thought to be in part responsible but the major factor is the inherent problem of communication which exists almost universally in people who suffer from mental handicap. Ways of improving the situation are discussed with an emphasis on the need for a change in our attitudes towards mentally handicapped people. Reference is made to the desirability of increasing the cooperation between primary care and community mental handicap teams and the increasing importance of voluntary organizations.