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
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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.
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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
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IQ DistributionIQ
Don't know/No
answer
24%
70 and Below
40%
71 and Above
36%
n=102
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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%
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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%
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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
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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%
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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%
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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
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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!
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