Colorado Dual Diagnosis Gap Analysis Preliminary Results Cordelia Robinson, PhD, RN Angela Rachubinski, PhD Kelly Stainback-Tracy, MPH, PT Sarah Hoover, M.Ed Cordelia.Rosenberg@ucdenver.edu (PI) 303-724-7680 1 Colorado Dual Diagnosis Gap Analysis Surveys Methods: • Publically available survey via a secure web link was circulated among local advocacy groups (https://redcap.ucdenver.edu/surveys/?s=9UMnVv). • Surveys available for: - Adult individuals with a dual diagnosis receiving services - Caregivers of individuals with a dual diagnosis - Providers of individuals with a dual diagnosis Of note: • The following results are descriptive only. • Results from 47 individuals have been excluded from this analysis because they did not meet the criteria of a dual diagnosis. • Results from 44 respondents identifying as “Other” have not been incorporated into these results. • Results from 3 adults receiving services are not included in these results. 2 Demographics n=102 Gender Male 70 Female 31 Age Age 8-12 29 Age 13-15 9 Age 16-18 19 Age 19-22 30 Age 23-30 Age 31+ 9 5 3 Developmental Diagnoses *Respondents could select more than one option* n=102 Autism Spectrum Disorder 67 Developmental Delay 35 Intellectual Disability 38 Down syndrome 6 Cerebral Palsy 8 Other Developmental Disability I don't know 18 4 4 Psychiatric Diagnoses *Respondents could select more than one option* n=102 Depression 35 Anxiety 69 Bipolar Disorder 24 Other Mood Disorder 35 ADD/ADHD 42 Psychotic Disorder Substance Abuse/Addiction 9 2 Other psychiatric diagnosis I don't know 28 3 5 Main reasons for ER visits *Respondents could select more than one option* 100 80 65.3 Of respondents having used ED (n=72) (%) 60 48.6 40 26.4 19.4 20 5.6 0 Threat to others/property Self-injury Thoughts of Suicide Other Medication refill ‘Other’ responses • Acute medical needs • Management of chronic medical needs due to behavior • Run Away 6 IQ DistributionIQ Don't know/No answer 24% 70 and Below 40% 71 and Above 36% n=102 7 Insurance type for individuals IQ with IQ < 70 Mental Health Insurance (n=41) Primary Insurance (n=41) *Respondents could select more than one option* Does not receive MH services 10% Other 5% Private (Private, Tricare) 49% Public (Medicare, Medicaid, CHP+) 46% Other (Other, Out of Pocket) 27% Public 45% Private 18% 8 Insurance type for individuals with IQ 71+ Primary Insurance (n=37) Other 3% Private (Private, Tricare) 54% Mental Health Insurance (n=37) *Respondents could select more than one option* No primary health insurance 3% Public (Medicare, Medicaid, CHP+) 40% Does not receive MH services 11% Other (Other, Out of Pocket) 33% Public 30% Private 26% 9 Services Received 100 80 IQ ≤ 70 Receiving services (%) (n=41) 60 40 20 0 Community Centered Board Community MH Center Community Centered Board Community MH Center School MH Services 100 80 IQ ≥ 71 Receiving services (%) (n=37) 60 40 20 0 School MH Services 10 Recurring comments for needed services • Wrap-around care/support – Many families receiving services/therapies state that any one service meets their child’s needs “a little” or “somewhat” (data not shown). • Access to needed care - regardless if diagnoses or lack thereof • Support for the entire family unit • Day Camp; Longer term camps • Respite care with trained staff • Family therapy/classes • Living options for transitioning adults • Living/other supports for higher-functioning individuals • Need for provider training/more options for crises 11 GAP Analysis Provider Data Provider Practice Setting N=100 *Providers able to select more than one type of practice setting* Other 19% Private Practice 11% Hospital 15% Direct Service Provider (DSP) 21% School 11% Mental Health Center 23% 12 GAP Analysis Provider Data Respondents Years in Practice (n=100) 40 30 20 10 0 0-5 years 6-10 years 11-15 years 16-20 years More than 20 No answer years No answer 4% Have you had PREVIOUS TRAINING in caring for this population? No 34% Yes 62% 13 GAP Analysis Provider Data Have you ever had to turn down seeing an individual from this patient population? (n=100) No answer 2% No 48% Yes 50% Most common reasons for refusal: • Presenting problem not covered by Medicaid/insurance • No insurance/lack of funding • Already had full caseloads 14 GAP Analysis Study The State of Colorado is supporting a cross-systems analysis of crisis intervention services. This analysis will look at the capacity to serve all individuals with dual diagnoses of an Intellectual or Developmental Disability and a Mental Health or Behavioral Disorder. This population includes individuals with Autism, Asperger’s Syndrome or PDD-NOS who have co-occurring Mental Health or Behavioral Disorders. We are also interested in individuals with Developmental Disabilities who, for psychiatric or behavioral reasons, have used Emergency Medical Services or been hospitalized. We want to hear the perspectives of people in these situations even if they do not technically have a Mental Health or Behavioral Disorder. We invite you to take our survey online at https://redcap.ucdenver.edu/surveys/?s=9UMnVv. The results of this survey will be reported as a summary and no one will know which responses are yours. Please feel free to pass the survey link onto anyone you think might be interested in responding. Our hope is that, with your help, we will be able to provide recommendations on how to better meet the needs of this population. We will post the results of the survey on the Colorado CANDO and JFK Partners websites. We appreciate you sharing your experiences. Please know that every voice is heard. Thank you for your participation! 15