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Viewing: Guiding Principles Regarding Serving Those with Co-Occurring Behavioral Health Disorders and Developmental Disabilities, 04-110

Current Status: Active PolicyStat ID: 149283

Guiding Principles Regarding Serving Those with Co-Occurring Behavioral Health Disorders and Developmental Disabilities, 04-110

Replaces Previous Policy #6203-102

Applicability

All DBHDD Services:  Hospitals, Community Providers of Mental Health, Addictive Diseases, and Developmental Disability Services

POLICY

The publicly funded MHDDAD system in Georgia aspires to be highly responsive to the multiple and complex needs of persons and families experiencing co-occurring behavioral health disorders and developmental disabilities, in all levels of care, across all system providers, throughout all phases of services.

Purpose

The design, delivery, and evaluation of Georgia's MHDDAD system must be fully responsive to adults and youth with co-occurring behavioral health disorders and developmental disabilities (DD).  People with intellectual disabilities and/or other developmental disabilities experience the full range of psychiatric disorders at rates higher than the general population. Based on national estimates a minimum of 7% - 20% of individuals with developmental disabilities will experience concurrent mental illness.  Behavioral health disorders are misdiagnosed, under-diagnosed, or undiagnosed in this population. Children and adults with multiple disabilities often require services simultaneously delivered by different service providers and systems. Complex needs require organizations to work collaboratively to develop and coordinate services and supports in the community.

Definition

Behavioral Health Disorders – For the purpose of this policy, the term Behavioral Health Disorder is used to describe a health condition in which an individual is diagnosed with serious mental illness, or is dually diagnosed with serious mental illness and addictive disease.

Guiding Principles and Expectations

  • Individuals with developmental disabilities can benefit from mental health services.
  • If a person has a diagnosis that qualifies for mental health services, the presence of any other diagnosis, including intellectual disability, does not exclude that individual from receiving mental health services. Intellectual level in and of itself does not qualify or disqualify a person if a particular diagnosis is adequate to justify the need for mental health services.
  • Coordinated treatment and support should be the standard for individuals with more than one disability who are served by the MHDDAD system.
  • When an individual has needs which can not be appropriately met by a single disability service, it is incumbent upon those in the MHDDAD system to make sure that other needed disability services are identified and accessed.
  • Concurrent enrollment in developmental disability services does not prohibit access to mental health services.
  • Concurrent enrollment in behavioral health services does not prohibit access to developmental disability services.
  • The individual must meet the criteria for the specific service(s) being provided.  This requires clinically defining the person's needs, wishes, and their ability (with reasonable accommodations) to benefit from the specific service(s).
  • The issue of "which came first?" is not relevant.  Phrases such as "primary diagnosis" should not be used in determining service delivery to persons with mental illness and developmental disabilities.
  • Providers of behavioral health services may not exclude individuals from receiving their services based on the fact that an individual has a developmental disability. Providers of DD services may not exclude individuals from receiving DD services simply based on the fact that the individual has a behavioral health diagnosis or is prescribed psychotropic medications.
  • Proper Assessment is essential in order to address the needs of individuals who have a developmental disability and a behavioral health need.  For guidance regarding assessment, see Attachment A – Best Practices for Mental Health Assessment of Persons with Developmental Disabilities.

While endorsing these guiding principles and expectations regarding co-occurring behavioral health disorders and developmental disabilities, the Division of Mental Health, Developmental Disabilities & Addictive Diseases also recognizes the difficult balance involved in addressing the needs of individuals given current constraints related to:

  • Funding,
  • Workforce development challenges, and
  • The gap between current practice and state of the art evidence-based practices.

Therefore, the Division has identified best practices standards that Georgia aspires to achieve as our MHDDAD system improves services and supports provided for those with co-occurring behavioral health disorders and developmental disabilities.  These best practice standards include the following:

  • Individuals with developmental disabilities are afforded access to a behavior support plan in order to address challenging behaviors, reduce the risk of over-medicating, and achieve a meaningful life in the community.
  • Individuals with developmental disabilities receive mental health services from staff that are specifically trained and experienced in working with developmental disabilities. Staff working in developmental disability settings who serve individuals with co-occurring behavioral health disorders are knowledgeable about behavioral health. Integrated treatment approaches are recommended.
  • Providers at the local level are strongly encouraged to develop collaborative agreements with providers of the other disability services.
  • Multi-dimensional assessment and treatment approaches include consideration of biological, psychological, social, and developmental factors.

References

National Association of State Directors of Developmental Disabilities Services (NASDDDS): http://www.nasddds.org/resource-library/behavioral-challenges/co-occurring-conditions/

keywords: Dual Diagnosis
Attachments:

Approval Signatures

Approver Date
Joetta Prost, Ph.D.: DBHDD Policy Director 12/8/2011
Approver Date
Joetta Prost, Ph.D.: DBHDD Policy Director 12/8/2011
Older Version Approval Signatures