The Fleming index of dysphagia was used to determine the prevalence of dysphagia in patients in a long-term, neuropsychiatric medical center. Prevalence varied by section, with the ventilator-dependent patients having the highest rate and the chemical-dependent patients having the lowest. The Fleming index appears to be a quick and useful instrument to identify patients who are at risk of dysphagic complications, but further reliability and validity studies are needed to demonstrate its utility.