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NADD U.S. Policy Update (from the NADD Bulletin Volume XII Number 4)
Complete listing
THE IMPORTANCE OF INTEGRATED SERVICES IN A DOWNTURNED ECONOMY
Eileen Elias, M.Ed. and Diane M. Jacobstein, Ph.D.
Apportioning scarce resources is an essential activity of economics.
Economics takes on a disturbingly human face when the scarce
resources are facilities and services and the recipients are
individual children and adults with co-occurring developmental and
emotional disorders. The stakes are high since the risks
include homelessness, institutionalization, or criminalization. In
this current economic recession, it is more necessary than ever to
stop the historic "ping-pong" approach that is typically
used among mental health and developmental disability agencies and
other state authorities to determine eligibility and funding. It is
no longer acceptable to dispute or ignore the necessity for
coordinated and integrated services, where each state's service
systems and authorities mutually plan and work together to address
the complex needs of these individuals.
States' current fiscal challenges are resulting in budget decisions
based on the near-term bottom line rather than on enlightened health
policy. Each time a family is forced to give up custody to obtain
services for their child, the costs are shifted to either the social
services or the criminal justice system. When the behavioral
health issues of the adult with developmental disabilities are not
addressed and become unmanageable, the costs are shifted to homeless
shelters, the judicial system, or other state institutions.
This is short-sighted, because when society does not deal
comprehensively with individuals' complex needs that cut across
agencies, the state or local government often becomes the caregiver
of last resort anyway. This only increases the likelihood that
the most restrictive and expensive placements will be used.
Additionally, some states that applied for and were awarded Medicaid
discretionary funds are now declining them out of concern that the
federal allocation or the state's match would not be available in
future budgets. It is unfortunate that a more comprehensive
policy review did not assess the "downstream" costs of
preventable institutionalization, homelessness, and criminalization.
During this economic crisis, there are solutions that can benefit the
child and adult with co-occurring disorders. Two actions are needed:
1.Maximize the effectiveness of available resources through creative
partnerships. This is achieved by two means. The first is to
eliminate administrative duplications (e.g., redundant screening and
assessment processes) and divide service tasks realistically. The
second is to foster free communication among the mental health and
developmental disability state authorities, and all other relevant
agencies (such as education, child welfare, and juvenile justice) as
well as service providers. All need to be willing to plan on how to
"pool" or "braid" respective resources, both
economic and professional, and to identify ways to provide jointly
supported services that prevent escalation of behavioral health
issues yet maintain one entity's lead responsibility.
2.States should reassess the potential benefit of Medicaid
discretionary grants for individuals with complex needs by reviewing
the cost-benefit of this federal funding. They can examine how
these funds could enhance the ability to support children and adults
in community-based services, preventing clinically unnecessary
institutionalization, homelessness, or criminalization.
The benefits of these actions are potentially far-reaching. In a time
of growing homelessness, it is especially important to keep adults or
youth with co-occurring disorders in needed community-based services
rather than on the streets. Developmental disabilities,
education, mental health, and other state authorities can benefit
from the more streamlined provision of services. The challenge
is recognizing that partnership planning is needed in order to
"do more with current funds." Several states have
recognized this need and have undertaken statewide planning for
either child or adult services.
Contact Information
Eileen Elias, M.Ed.
Senior Policy Advisor for Disability and Mental Health
JBS International, Inc.
Prior Commissioner for Mental Health, Massachusetts
Former Deputy Director, DHHS Office on Disability
eelias@jbsinternational.com
Diane M. Jacobstein, Ph.D.
Clinical Psychologist/Sr. Policy Associate
Research Associate Professor, Pediatrics
Georgetown TA Center for Children's Mental Health
jacobstd@georgetown.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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