It will help meet all of the needs that a person with IDD and MH may have and support us as we develop a comprehensive plan.

Best practice is to use an integrative approach. The integrative approach is also referred to as the bio-psychosocial approach. A team-based family driven approach where mental health care, social needs, environmental supports and general medical care are offered in the same setting.

In this approach we are trying to be more comprehensive. We are looking at all aspects of the individual and his social and cultural background.

When we include all of the different areas and consider how they interrelate, we are going to get a more complete and accurate assessment.

The integrative approach identifies the supports that are needed and takes a proactive focus. It is a team approach using the expertise of multiple disciplines. Just as we plan in school to assist the individual student to have a smooth transition to adult life, we also want to consider, plan and prepare for transitions in treatment.

The medical home is best described as a model or philosophy of primary care that is patient-centered, comprehensive, team-based, coordinated, accessible, and focused on quality and safety. It has become a widely accepted model for how primary care should be organized and delivered throughout the health care system, and is a philosophy of health care delivery that encourages providers and care teams to meet patients where they are, from the most simple to the most complex conditions. It is a place where patients are treated with respect, dignity, and compassion, and enable strong and trusting relationships with providers and staff. Above all, the medical home is not a final destination instead, it is a model for achieving primary care excellence so that care is received in the right place, at the right time, and in the manner that best suits a patient’s needs.

In 2007, the major primary care physician associations developed and endorsed the Joint Principles of the Patient-Centered Medical Home. The model has since evolved, and today the PCPCC actively promotes the medical home as defined by the Agency for Healthcare Research and Quality (AHRQ).

Using an integrative approach requires that team members understand the concept and work together to gather the information for the assessment.

An assessment for a person with IDD will and should take longer and be more involved than for a person from the general population, and we need to understand that the thoroughness will pay off with a better intervention plan and better results.

In the long run, if we solve problems we are seeing currently, we will likely have to do less problem solving down the road

Does this remind you of person centered support planning? Or Wraparound? An individual’s person centered planning or Wraparound team would likely be involved.

The Utah Parent Center’s workshop and materials on person centered planning has a lot of ideas that would apply to the way we diagnose and serve an individual with dual diagnosis. Allies with Families has more information about High Fidelity Wraparound.

Ensure confidentiality laws are followed.

*Remember, the point of getting a diagnosis is to provide the starting place for a treatment plan. The diagnosis should include recommendations for treatment. This clinician or another clinician should play the role of following up and guiding treatment. If the clinician who makes the diagnosis cannot guide the treatment, then you could ask for recommendations and that there be some communication between the two.

If possible, choose a clinician familiar with Dual Diagnosis—One who can look at all the possible reasons for the behavior or problem.

Remember there are hundreds of possible diagnoses in the DSM-5, (Diagnostic and Statistical Manual of Mental Disorders) although just like in the general population, these are a few that are most commonly diagnosed.

Here are a few for you to consider. Other questions are included in the handout section.

• Contact your insurance regarding Mental Health coverage.
• Find out if this provider is a team player or is willing to work with others who are already on your team
• Ask your doctor or other professionals you trust for recommendations.
• What is this person’s approach to treatment?

Does the Mental Health provider know how to adapt therapy for a person with intellectual or developmental disabilities?
Do I think this person will be a good match for my family member? Does this person seem to understand my child’s specific needs?
There are many other questions to think about. This could start the process – other questions may come to mind. Write them down.
When you go to the appointment, take the questions you have with you and be sure to take notes.

There are organizations that provide many educational resources and that can support you as you navigate new and perhaps uncharted territories.