Deinstitutionalization Effects on Medication Use for People with Mental Retardation

Date of Award


Document Type


Degree Name

Doctor of Philosophy (PhD)




Historically, patterns of psychoactive medication use in institutional settings for people with mental retardation were considered excessive. Service standards substantially reduced levels of such medication use. Similar research in community settings has been limited, but comparisons between the two settings are fraught with complicating variables. Rapid deinstitutionalization in North Dakota provided a unique opportunity to follow the medication use patterns of people who stayed and those who left the institution. Follow up time periods were selected for statewide accreditation (1989) and several years later through which those standards have been consistently met (1995). Psychoactive medication use decreased with the onset of standards for the entire population, and decreased for the people both within institution and community settings by 1989. Medication use was highly similar between institution and community settings at each time point, but medication use returned to near prestandards institutional levels no matter where the individual resided by 1995, the important exception being neuroleptics. Neuroleptic use remained stable at the lower level established in 1989.

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