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NADD U.S. Policy Update (from the NADD Bulletin Volume XII Number 3)
Complete listing
Planned Clinical Respite Services for Individuals with Intellectual
Disabilities/ Mental Illness and Their Families
Joan B. Beasley, Ph.D., Director for START Services, UNH Institute on Disability/UCED
Throughout the United States, there is a growing trend to improve
community services and supports with the provision of emergency or
crisis respite beds outside the individual's home. This is an
important service and the need should not be underestimated. Many
individuals with intellectual disabilities and mental/behavioral
health service needs may not require psychiatric inpatient stays but
may require short term facility-based support to assist the
individual and their caregiver during a time of acute difficulty. In
addition, the expected length of stay in psychiatric inpatient
facilities may require the use of transitional clinical respite as
the next step before the return home. Furthermore, we have learned
from experience that temporary removal from the place in which
difficulties arise can help to inform caregivers about what is needed
to prevent future problems. This is especially true if collaboration
with the caregiver and an assessment of the crisis situation take
place in the context of the provision of respite.
Historically, policy planners have underestimated the number of
individuals and families who would benefit from planned clinical
respite in order to avoid emergency situations and to assist families
and individuals in need of a brief break. We know that for families
of individuals with co-occurring disorders, access to services
designed to support families may not be available due to the unique
needs of their loved ones. Planned clinical respite is intended to
serve individuals who have not been able to use respite in more
traditional settings due to their on-going mental health and/or
behavioral issues.
Planned clinical respite reduces strain on families, allows for
ongoing assessment, caregiver and individual support, and offers a
place to go for brief out-of-home stays. Providers of this service
should be highly skilled; while providing a positive and recreational
atmosphere, they also evaluate the individual's behavioral health and
ongoing support needs. Typically, planned respite stays are on
average a maximum of three days per visit, but can be as long as one
week per visit.
The needs of families are often under-represented in program planning
when it comes to planned clinical respite in spite of the fact that
providing support to these families is both people-centered and cost
effective. For example, the cost of 36 days a year (3 days a month)
of planned respite, along with needed clinical and crisis prevention
support is approximately $14,000 a year for an individual living with
his or her family, while the cost of residential placement for
the individual with co-occurring needs is on average $125,000 a year.
Sometimes improved public policy initiatives arise from a need to
explore options more carefully during times of financial difficulty.
It is my hope that more states will now consider the benefits of
planned clinical respite for individuals who reside with their
families to avoid unnecessary emergency room visits, hospitalizations
that can often result in permanent residential placements during this
time of severe fiscal constraint.
Related References
Lunsky, Y., Gracey, G., & Gelfand, S. (2008). Emergency
psychiatric services for individuals with intellectual disabilities:
Perspectives of hospital staff. Intellectual and Developmental
Disabilities, 46(6), 446-445.
Weigle, K., Rubin, L., Phillips, J. & Fahs, J. (2006). The
TN-START Annual Report . Report submitted to national advisory
council of the TN START program. Chattanooga, TN: Team Centers.
Beasley, J.B. (2002)."Trends in coordinated and planned mental
health service use by people with dual diagnosis". In J.
Jacobson & R. Fletcher (Eds.) Contemporary dual diagnosis: MH/MR
service models, Volume II: Partial andsSupportive services (pp.
35-51). Kingston, NY: NADD
For further information, please contact Dr. Beasley at Joan.beasley@unh.edu,
The "U.S. Public Policy Update" is an ongoing column in The
NADD Bulletin. We welcome your comments and submissions for
this column. To learn more or to contribute to this column you
may contact Joan Beasley, Editor of the U.S. Public Policy Update at joan.beasley@unh.edu.
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Upcoming Conferences:
September
Ohio State 10th Annual MI/DD Conference , Mental Health Aspects
–Treatment & Support (September 18 & September 19, 2012)
Columbus, Ohio
October
NADD 29th Conference & Exhibit Show, (October 17 - 19, 2012)
Denver, Colorado
October 2013
NADD 30th Conference & Exhibit Show, Baltimore MD (October 23 -
October 25, 2013)
Complete Calendar |
New Educational Products:
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 Intellectual
Disability and Mental Health: A Training Manual in Dual Diagnosis
Sharon McGilvery, Ph.D. and Darlene Sweetland, Ph.D.
With the release of this book, Drs. McGilvery and Sweetland share
decades of experience working with individuals diagnosed with an
intellectual disability and co-occurring psychiatric disorders. Their
well-practiced approach takes into account the extremely complex
nature of working with dual-diagnosis. The authors provide
in-depth information about the diagnostic process, hands-on treatment
considerations, and their experience training thousands of people to
work passionately with these individuals. An important
contribution is their approach to addressing complicating factors in
identifying appropriate psychiatric diagnoses, as well as the problem
of the underreporting of psychiatric symptoms and disorders. Finally,
those working in a variety of contexts with these individuals will
benefit from the innovative approaches of looking at treatment and
intervention strategies that can be immediately implemented. 264 pages
Details:
ST11-053B
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 A
PRACTICAL GUIDE to Assessing Medical Issues Associated with
Behavior/ Psychiatric Problems in Persons with Intellectual
Disability – Revised in 2011
Ann R. Poindexter, M.D.
This book discusses medical/medication issues which may present as
behavioral/ psychiatric problems in individuals with intellectual
disability. Three self-directed instructional courses and
several illustrative case histories are included. 110 pages\
Details:
DA05-021BR
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Psychotherapy for Individuals with Intellectual Disability
Edited by: Robert J. Fletcher, DSW, ACSW
This book provides the reader with insightful and useful ways to
provide psychotherapy treatment for individuals who have intellectual
disability (ID). It brings together all three modalities
(individual, couple, and group), and a variety of theoretical models
and techniques are discussed. The first section, Individual
Therapy, offers a variety of approaches and techniques including
dialectical behavioral therapy, positive psychology,
mindfulness-based practice, and relaxation training. Also included in
this section are chapters on specialty populations including victims
of abuse, people who have Autism Spectrum Disorder, and people in
mourning. The second section is a chapter on group therapy addressing
trauma issues. The third section is on family and couple therapy. The
fourth section covers chapters on research, ethics, and
training. The individual authors are respected authorities in
the field of providing psychotherapy treatment for persons with ID
and all have contributed to the professional literature.
This book is a major contribution to the effort to make psychotherapy
available to individuals who have ID and should serve to further
stimulate interest in the provision of psychotherapy treatment for
individuals who have ID co-occurring with significant mental health problems.
NADD # CT11-051B Details
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 Comprehensive
Competence-Based Parenting Assessment for Parents with Learning
Dificulties and Their Children
Maurice Feldman, PhD, Marjorie Aunos, PhD
This book presents an innovative, empirically-supported approach to
assessing parenting capacity of parents with learning difficulties
that can lead to more humane, fair and accurate child custody
decisions. The authors are leading researchers and
practitioners in this field haing worked with hundred of these
families. Many professionals working with these families
recognize that the current parenting capacity assessment approaches
are based on outdatd and invalid assumptions and methods. This
book addresses the unique assessment needs of these families and
includes detailed background information, rationales and methods.
NADD # DA10-050B Details
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 Working
with People with Challeging Behaviors: A Guide for Maintaining
Positive Relation
Nathan Ory
The material in this book introduces general practices
and specific solutions to behavior problems that will work with
people who display difficult and challenging behaviors regardless of
who they are. It is especially suitable for working with
individuals who have developmental or intellectual disabilities
coupled with a behavior disorder. The methods also apply to the
person with emotional or psychiatric disturbances, or another serious
mental health problem. Finally, they are helpful in providing
support to elderly individuals who display challenging behavior.
NADD # ST10-049B Details
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Human Needs and Intellectual Disabilities: Applications for Person
Centered Planning, Dual Diagnosis, and Crisis Intervention
Steven Reiss, Ph.D.
Human Needs and Intellectual Disabilities identifies the 12 human
needs most relevant to the lives of people with intellectual
disabilities, autism and related developmental disabilities. It
includes detailed, practical suggestions for caregivers or parents
interested in the happiness, quality of life, and self-determintion
of their loved ones or consumers. The book includes detailed,
practical suggestions for reducing episodes of challenging behavior
and psychiatric symptoms in people with a dual diagnosis
(intellectual disabilities and mental illness). It shows how to
substitute the language of individuality (e.g., "friendly
person") for the language of disability (e.g., "person with
disability"). It also reduces the tendency of planners to
confuse their own value system for that of the consumer. The
book includes scholarly reviews of dual diagnosis literature on
mental illness, prevalence, and assessment.
NADD # DA10-048B Details
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Positive Identity Development
Author: Karyn Harvey, PhD
Positive Identity Development is an exciting new approach to
treatment for individuals with intellectual disabilities. This
book provides a new theoretical perspective on treatment along with a
variety of innovative tools. It rejects reducing adults with
intellectual disabilities to a mere compilation of their behaviors
and promotes the use of a positive, therapeutic approach to each
unique individual. Psychologists, social workers and therapists
should be able to use the tools presented in this book to directly
enhance the effectiveness of the treatment they provide to adults
with intellectual disabilities. This book promotes well-being on
every level and explores a broad range of issues relevant to the life
and mental health of adults with intellectual disabilities
Mbr Price: $34.95
Non-Mbr: $39.95
NADD #CT09-047B Details |
 Down
Syndrome: When to Worry about Mental Health and What to Do About It
Robin Friedlander, M.D. & Peter Johnson, Ph.D.
NADD # FI09-044B Details |
 Working
with People who have Intellectual Disability and Behavioral
Problems: A Self-Study Guide for Interdisciplinary Team Members
Ann R. Poindexter, M.D. & Paul D. Kolstoe, Ph.D.
NADD # ST09-045B Details |
Multi-Media CDs of NADD 25th Annual Conference Presentations
Presentations recorded at NADD 25th Annual Conference are available
as multi-media CDs. These CDs contain the video and Power Point
from conference presentations and are a great tool for training
yourself and your staff. To order, or for additional
information, click here.
Community Networks of Specialized Care: Building Community
Capacity through Training and Education Lisa Holmes, Liz
Froese, MSW, Rosanne Stein, LLB, BSc, Sandi Bricker
NADD Competency-Based Dual Diagnosis Certification Program Robert
Fletcher, DSW, ACSW, FAAIDD; Donna McNelis, PhD; John McGonigle,
PhD; Kathleen Olson, PhD; Jarrett Barnhill, MD
Autism Spectrum Disorders: Separating the Data from the
Myths Ann R. Poindexter, MD
Diagnostic Systems for Use with People with ID Luis
Salvador-Carulla, MD, PhD, Robert J. Fletcher, DSW, ACSW, FAAIDD,
Sally-Ann Cooper, MD
The price for the above multimedia is: Member:
$49.95 Non-member: $59.95
To order, or for additional information, click
here.
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