Renovations

Supporting Dual Diagnosis in a Community Based Residential Setting: An Intensive Inter-Personal Relationship Based Approach

The need for services supporting individuals who have been diagnosed as having both a Developmental Disability and a co-existing Psychiatric Disorder has increased dramatically over the course of the last several years. Numerous approaches to supporting this population have been attempted with most finding limited success. The Arc of the Ozarks in Springfield Missouri began a small program in 2004 to address the needs of this specific population. The program is based on developing intensive inter-personal relationships with residents served. Staff base many of the interventions used in this program on The Paraclete Model. A Paraclete is defined as "an advocate, intercessor, pleader, or comforter" or in simple terms "one who walks alongside". The Renovations Program (as it is referred to today) supports over 60 individuals (male/female), in the Springfield and Joplin areas, with a staff of over 150 individuals who have been specifically trained to focus on interpersonal relationships. We currently have a four person female group home and an eight person male group home with two of those beds being reserved for males who are in need of short term stabilization services.

According to the National Association for the Dually Diagnosed (NADD) 20 - 35% of individuals with Developmental Disabilities have a Dual Diagnosis.
According the The Arc website incidence of Dual Diagnosis in community based agencies ranges from 10 - 40% and 10 - 20% for the general population.
- single most common mental health problem is poor social skills
- personality disorders are common
- 1 in 5 individuals have conduct or behavioral problems
- 3 - 6% have an affective disorder
- rates are higher in adults than in children
- higher rates are associated with mild versus severe MR
- rates are equivalent for males and females
Current systems are set up to treat either Mental Illness or a Developmental Disability not both.
Community based services often are unavailable or inadequate.
Eighty percent of individuals with a Developmental Disability in state hospitals have a Dual Diagnosis.
- stay in state hospitals is 3x longer
- are more likely to be placed in restraints during their stay

Sources

Mental Illness in Persons with Mental Retardation - The Arc website

Serving Individuals with Co-Occurring Developmental Disabilities and Mental Illnesses: Systems Barriers and Strategies for Reform - National Association of State Mental Health Program Directors (NASMHPD)

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