My cousin has always been considered “slow” or “different,” but I’m starting to wonder whether his problems stem from a mental illness or some form of mental retardation. What is the difference between mental illness and mental retardation? How is treatment different?
 

By definition, mental retardation is characterized by significantly sub-average general intellectual functioning. In addition, people with mental retardation experience limited ability to adapt to the demands of daily living as evidenced by limited communication, self-care, and social and academic skills. Mental retardation is usually diagnosed in childhood. Impairments in functional ability level can range from mild to profound.

In contrast, there are many different forms of mental illness. Among the most common disorders are schizophrenia and other psychotic disorders, mood disorders, anxiety disorders and personality disorders. These conditions can be diagnosed in childhood, but may not be evident until the individual reaches adolescence or young adulthood.

Mental retardation and mental illness are not mutually exclusive. For example, people with schizophrenia may experience a decline in their intellectual functioning as a result of the progression of the disorder. Diagnostic tests to measure intelligence require reasoning, planning, discrimination, speed of performance and analytical skills. These abilities are compromised by the impact of the symptoms of schizophrenia: delusions, hallucinations, disorganized speech, or paranoia.

Treatment for mental retardation includes specialized instruction with personalized supports.  Special services often include individualized education programs, communication therapy, occupational or physical therapy, and behavior therapy, and are generally more effective in addressing the special needs of the person with mental retardation when they begin in early childhood.  In general, medication is not used to treat developmental disabilities such as mental retardation. People with mood disorders, such as Major Depression or Bipolar Disorder, are often treated with a combination of medication and talk therapy. Similarly, people with anxiety disorders typically respond to the combination of medication and talk therapy. Research has shown that people with schizophrenia are less responsive to talk therapy. These individuals rely upon medications and community supports to help them navigate the demands of every day living. What both groups have in common, those with mental retardation and those with mental illness, is the need for accommodations in order to reach adulthood with the greatest level of independence. Choice and self-determination are key to planning and implementing these accommodations. Parents, teachers, other caring adults, and the community at large must provide opportunities for learning, communicating, socializing and working that match the skills and aspirations of these unique individuals. By including people with developmental and emotional disabilities in our schools and communities, we help reduce the stigma of mental disorders that, unfortunately, persists in our society. Ultimately, people with mental retardation and those with mental illness will benefit from societal inclusion with improved functioning and meaningful participation.   

Karen Walsh
Effective Practice Specialist: Psychological Services
Special School District of St. Louis County

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