Community capacity to provide mental/behavioral health services to people with developmental disabilities

The United States' long history of providing services to people with intellectual and/or developmental disabilities (IDD) in large public congregate settings has been in reversal over the past four decades. Since peaking in 1967 (U.S. Department of Health, Education and Welfare, 1972), census reduction of such facilities has occurred at an average annual rate of 5% nation-wide (Braddock et al., 2013). Despite having closed four state operated developmental centers (SODCs) since 1982, Illinois continues to be among states with the highest rates of institutionalization of persons with IDD in the country, although efforts are being made to change this through the Governor's Rebalancing Initiative. A longitudinal analysis of institutional depopulation in Illinois revealed that the majority of individuals who transitioned out of an SODC and were readmitted returned due to behavioral issues. The aim of this study, therefore, was to explore the capacity of community-based providers of residential supports and services, as well as the surrounding community, to provide behavioral and mental health services to individuals who transition out of an SODC. Results indicate a need for strengthening of the mental/behavioral health system available to adults with IDD in four ways: strengthen technical assistance and crisis response to behavioral issues; enhance the availability of community-based mental/behavioral health professionals through training; improve collaboration between state developmental disability and mental health agencies; and increase Medicaid reimbursement rates. Additionally, the need for continued investigation of environmental factors and community capital contributing to post-deinstitutionalization outcomes for people with IDD is implicated. Finally, the need for continued exploration of programs addressing challenges to community living experienced by persons with IDD and behavioral concerns is highlighted. As the U.S. continues to move toward a lessened reliance on publically funded state-operated congregate settings, monitoring of outcomes of individuals who have transitioned to other settings and examining factors contributing to these outcomes is imperative.