This is a detailed analysis of the Mental Handicap Registers in the North West Thames Region, London. It gives insights into the problems faced by handicapped individuals, their parents and the authorities responsible for providing services.;The incidence of mental handicap has remained fairly static over the decades, but there is an increase in life expectancy, with a resulting increase in prevalence. Quality of life is an important factor. The challenge is to create an environment where individuals can attain their maximum potential without prejudicing others. With its extensive discussion of the issues involved, this text should be beneficial to all professionals involved in implementing changes in services and anyone with an interest in improving quality of life for mentally handicapped people.