A TARDIVE DYSKINESIA CLINIC IN A MENTAL HEALTH CENTER

UThe widespread prevalence of tardive dyskinesia means that mental health facilities are faced with the need to assess and treat a large number of patients with this disturbing affliction. Treatment approaches to tardive dyskinesia have been well described (1-4), but little has been written about the methods by which patients with tardive dyskinesia can be identified and referred for treatment. Bell and Smith have described a systemic approach to the characterization of tardive dyskinesia in the Illinois state hospital system (5). A few outpatient treatment settings, generally with academic affiliations, have developed “tardive dyskinesia clinics” that tend to the problem from a research perspective. However, to our knowledge no one has described an organized specialty clinic designed to treat patients with tardive dyskinesia. In this paper we report on such a clinic: the Yale University School of Medicine Tardive Dyskinesia (TD) Clinic at the Connecticut Mental Health Center in New Haven. The TD Clinic was established in 1978 with the following goals: to offer clinical evaluation, consultation, and treatment to patients with tardive dyskinesia; to carry out research on the etiology and treatment of the disorder; and to provide educational consultation to facilities on detection, treatment, and prevention. The clinic is located in the outpatient division of the Connecticut Mental Health Center, which serves a population of 450,000 people. At any given time, approximately 2,000 patients are enrolled in outpatient treatment at the center, and another 1 ,000 are enrolled in its satellite services. Most of the 700 patients receiving antipsychotic medication on a maintenance basis are seen by a treatment team consisting of nonphysician