Illness Management and Recovery for People with Mental Illness and Intellectual Disabilities

Abstract

the Needs of the Population

A small number of people who have intellectual disabilities consume a large number of resources and often receive very little benefit. These are individuals who also have significant mental illness and are often discharged from traditional services because of their challenging behaviors and lack of response to intervention. The annual cost to serve one person can exceed $250k just for their residential supports.

These individuals normally require intensive and expensive amounts of direct service, twenty-four hours a day. They often receive psychotropic medication but, if asked, will say they don’t think it is working. And while some behavior support may be offered, the mental illness is rarely addressed. In fact, there are professionals who doubt that someone with an intellectual disability can have a mental illness. And some professionals think that a person with an intellectual disability cannot benefit from “talk”-based therapy.

We listened to the stories of people who got better only to understand that their cases involved the heroic efforts of residential services managers who were able to create effective care plans that were holistic in their approach, promoted the appropriate exchange of professional knowledge, and were sensitive to the person’s history and the needs of the caregivers providing support. These are stories of truly unique and laudable actions taken to make sure that the person in need could navigate the system and succeed. Individualized and extraordinary as they were, none of these stories gave us a roadmap to replication, so we gathered a small and determined team to learn and find a solution.