Supporting Dual Diagnosis in a Community-Based Residential Setting:
An Intensive Interpersonal Relationship-Based Approach
The need for services supporting individuals with a co-occurring developmental disability and psychiatric disorder and/or significant behavioral problems has increased dramatically over the last several years. Numerous approaches to supporting this population have been attempted with most resulting in limited success.
In 2004, The Arc of the Ozarks in Springfield, Missouri began a small program to address the needs of these individuals. The program was, and still is, based on developing intensive interpersonal relationships between residents being 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 80 individuals (male and female) in the Springfield area with a staff of over 300 individuals specifically trained to focus on interpersonal relationships.
Did you know?
According to the National Association for the Dually Diagnosed (NADD) 20-35% of individuals with Developmental Disabilities have a Dual Diagnosis.
According to The Arc's search for Dual Diagnosis in community-based agencies, the general population ranges from 10-40% and 10-20%.
The 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% of individuals have an affective disorder
Disorder rates are higher in adults than in children
Higher disorder rates are associated with mild vs. severe MR
Disorder rates are equivalent for males and females
Most current systems are set up to treat either Mental Illness or a Developmental Disability, not both.
Community-based services are often unavailable or inadequate.
Eighty percent of individuals with a Developmental Disability in state hospitals have a Dual Diagnosis.
Individuals with Dual Diagnosis stay in state hospitals 3x longer
These individuals are more likely to be placed in restraints during their stay
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)