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Published Online: 21 May 2024

Interagency Coordination to Manage Co-Occurring Intellectual and Developmental Disabilities and Mental Health Conditions

Abstract

Objective:

The authors aimed to identify barriers to and strategies for supporting coordination between state agencies for intellectual and developmental disability (IDD) or mental health to meet the mental health needs of people with co-occurring IDD and mental health conditions.

Methods:

Forty-nine employees of state agencies as well as advocacy and service delivery organizations across 11 U.S. states with separate IDD and mental health agencies were interviewed between April 2022 and April 2023. Data were analyzed with a thematic analysis approach.

Results:

Interviewees reported that relationships between the IDD and mental health agencies have elements of both competition and coordination and that coordination primarily takes place in response to crisis events. Barriers to interagency coordination included a narrow focus on the populations targeted by each agency, within-state variation in agency structures, and a lack of knowledge about co-occurring IDD and mental health conditions. Interviewees also described both administrative (e.g., memorandums of understanding) and agency culture (e.g., focusing on whole-person care) strategies that are or could be used to improve coordination to provide mental health services for people with both IDD and a mental health condition.

Conclusions:

Strategies that support state agencies in moving away from crisis response toward a focus on whole-person care should be prioritized to support coordination of mental health services for individuals with co-occurring IDD and mental health conditions.

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Supplementary Material

File (appi.ps.20230451.ds001.pdf)

Information & Authors

Information

Published In

Go to Psychiatric Services
Go to Psychiatric Services
Psychiatric Services
Pages: 770 - 777
PubMed: 38769909

History

Received: 5 September 2023
Revision received: 15 December 2023
Accepted: 4 January 2024
Published online: 21 May 2024
Published in print: August 01, 2024

Keywords

  1. Intellectual disability
  2. Mental illness
  3. Service delivery systems
  4. Administration and management

Authors

Affiliations

Elizabeth M. Stone, Ph.D., M.S.P.H. [email protected]
Rutgers Institute for Health, Health Care Policy and Aging Research, Rutgers University, New Brunswick, and Department of Psychiatry, Rutgers Robert Wood Johnson Medical School, Piscataway, New Jersey (Stone); Departments of Health Policy and Management (Jopson, McCourt) and Health, Behavior, and Society (German), Johns Hopkins University Bloomberg School of Public Health, Baltimore; Department of Population Health Sciences, Division of Health Policy and Economics, Weill Cornell Medicine, New York City (McGinty).
Andrew D. Jopson, M.P.H.
Rutgers Institute for Health, Health Care Policy and Aging Research, Rutgers University, New Brunswick, and Department of Psychiatry, Rutgers Robert Wood Johnson Medical School, Piscataway, New Jersey (Stone); Departments of Health Policy and Management (Jopson, McCourt) and Health, Behavior, and Society (German), Johns Hopkins University Bloomberg School of Public Health, Baltimore; Department of Population Health Sciences, Division of Health Policy and Economics, Weill Cornell Medicine, New York City (McGinty).
Danielle German, Ph.D., M.P.H.
Rutgers Institute for Health, Health Care Policy and Aging Research, Rutgers University, New Brunswick, and Department of Psychiatry, Rutgers Robert Wood Johnson Medical School, Piscataway, New Jersey (Stone); Departments of Health Policy and Management (Jopson, McCourt) and Health, Behavior, and Society (German), Johns Hopkins University Bloomberg School of Public Health, Baltimore; Department of Population Health Sciences, Division of Health Policy and Economics, Weill Cornell Medicine, New York City (McGinty).
Alexander D. McCourt, J.D., Ph.D.
Rutgers Institute for Health, Health Care Policy and Aging Research, Rutgers University, New Brunswick, and Department of Psychiatry, Rutgers Robert Wood Johnson Medical School, Piscataway, New Jersey (Stone); Departments of Health Policy and Management (Jopson, McCourt) and Health, Behavior, and Society (German), Johns Hopkins University Bloomberg School of Public Health, Baltimore; Department of Population Health Sciences, Division of Health Policy and Economics, Weill Cornell Medicine, New York City (McGinty).
Emma E. McGinty, Ph.D., M.S.
Rutgers Institute for Health, Health Care Policy and Aging Research, Rutgers University, New Brunswick, and Department of Psychiatry, Rutgers Robert Wood Johnson Medical School, Piscataway, New Jersey (Stone); Departments of Health Policy and Management (Jopson, McCourt) and Health, Behavior, and Society (German), Johns Hopkins University Bloomberg School of Public Health, Baltimore; Department of Population Health Sciences, Division of Health Policy and Economics, Weill Cornell Medicine, New York City (McGinty).

Notes

Send correspondence to Dr. Stone ([email protected]).

Competing Interests

The authors report no financial relationships with commercial interests.

Funding Information

This study was funded by the Johns Hopkins Institute for Health and Social Policy, the Johns Hopkins Wendy Klag Center for Autism and Developmental Disabilities, and NIMH (awards T32 MH109436 and F31 MH131311).

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