Proposal for Developing Appropriate Therapeutic Housing for Dually Diagnosed Individuals
In recent months, VOR has been working with the Link Center and the National Association of State Directors of Developmental Disabilities Services (NASDDDS) to improve supports for a unique cohort of individuals - children and adults with intellectual and developmental disabilities (I/DD) and autism who also experience mental health conditions.
For decades, our DD and Mental Health Systems have failed to acknowledge this problem or to treat these individuals. As a result, many of them languish in hospital psychiatric wards, live on the streets, or have been relegated to the prison system. They receive no treatment, no therapy, and minimal services.
Many of these individuals are caught between silos of services, where state DD services are not equipped to handle people with schizo-affective disorders and other mental health challenges, and state mental health departments have no resources for people who have originally been diagnosed with I/DD or autism.
Treatment for these individuals would require doctors, nurses, psychiatric technicians, and DSPs trained to address these co-occurring conditions, as well as staff prepared to predict and prevent aggressive behaviors and violent outbursts, and to be physically capable of responding to such incidents quickly when they do occur.
To date, HCBS services have not met this challenge. It is doubtful that private providers would ever take on the cost of providing such services in a 3 to 4 person group home, nor would they be willing to take on the risk to residents or staff during these violent episodes.
We need to act. As one small first step, VOR's Dual IDD/SMI Committee has produced a position paper outlining the need for these services and attempting to initiate a conversation with recommendations for how such services could best be established.