Mental Health Outcomes and Caregiver Service Experiences Associated with START Clinical Team Services Joan B. Beasley, Ph.D. Institute on Disability/UCED, University of New Hampshire Joan B. Beasley, Ph.D. www.centerforstartservices.org
Lets review what we have learned Institute on Disability/UCED, University of New Hampshire Joan B. Beasley, Ph.D.
IDD and Mental Conditions • Across the United States approximately 1.5% to 2.5% of the population has an intellectual developmental disorder (IDD). • The (DSM5) defines IDD as a disability that involves impairments of general mental abilities that impact adaptive functioning in three domains, or areas. • These domains determine how well an individual copes with everyday tasks. • Epidemiological studies have established that the incidence and prevalence of mental health conditions for people with IDD is typically 2 to 3 times that of the general population • and that these mental health conditions often contribute to challenging behavior. For people with IDD, aggression and self-injurious behavior are two of the most common reasons for referrals for mental health services. Institute on Disability/UCED, University of New Hampshire Joan B. Beasley, Ph.D.
Biopsychosocial Model Engel, 1977 • The biopsychosocial model (abbreviated "BPS") is a general model or approach stating that biological ( physical make up or condition) , psychological( thoughts, emotions, level of development, communication) and social ( socio-economic, environmental, cultural experiential influences) significant role in human functioning in the context of disease or illness. • Health is best understood in terms of the context of these combined factors rather than purely biological terms. • Used in mental health and humanistic psychology, family systems and other practices • Applied assessment of people with IDD and challenging behavior (Gardner) Institute on Disability/UCED, University of New Hampshire Joan B. Beasley, Ph.D.
The "START" model: • First developed in 1988, and still learning • KEY: Partnerships that Enrich the system • Nationally recognized • Let’s discuss our values Institute on Disability/UCED, University of New Hampshire Joan B. Beasley, Ph.D.
Capacity building begins with posi4ve engagement – Whether it is an individual or a large system, we emphasize building upon abili8es in each individual and in their system of support. Service recipients and their families are our most valued partners. Institute on Disability/UCED, University of New Hampshire Joan B. Beasley, Ph.D.
Help begins with providing oxygen - helping to resolve an immediate destabilizing situation allows for hope and change going forward. Institute on Disability/UCED, University of New Hampshire Joan B. Beasley, Ph.D.
The three A’s of service effectiveness - Access, Appropriateness and Accountability. Networking - increases depth of knowledge and capacity to provide services for all. Institute on Disability/UCED, University of New Hampshire Joan B. Beasley, Ph.D.
The 3 A’s Access (timely, available) Appropriateness (matches real needs, provides tools) Accountability (responsiveness, engaging, flexible, creative) Institute on Disability/UCED, University of New Hampshire Joan B. Beasley, Ph.D. 10/30/17
Institute on Disability/UCED, University of New Hampshire Joan B. Beasley, Ph.D.
Institute on Disability/UCED, University of New Hampshire Joan B. Beasley, Ph.D.
Institute on Disability/UCED, University of New Hampshire Joan B. Beasley, Ph.D.
Networking: Synergy and linkages (Buckminster Fuller) • A dynamic state in which combined action is favored over the difference of individual component actions. • Behavior of whole systems unpredicted by the behavior of their parts taken separately, known as emergent behavior • The cooperative action of two or more stimuli, resulting in a different or greater response than that of the individual stimuli. Institute on Disability/UCED, University of New Hampshire Joan B. Beasley, Ph.D.
The Benefits of Linkages Synergy: 1. Mutually comparable combined action or operation. 2. The interaction of elements that when combined produce a total effect where the sum is greater than its parts. Video Link Institute on Disability/UCED, University of New Hampshire Joan B. Beasley, Ph.D.
We must all be open to learning and teaching - through continuous assessment of outcomes along with educational opportunities with easily accessible local, regional, statewide, national forums, study groups and training materials. Institute on Disability/UCED, University of New Hampshire Joan B. Beasley, Ph.D.
Team effort - we work as a team to create opportunities. This includes mutual respect that allows for team input to help the program continue to improve and change over time Institute on Disability/UCED, University of New Hampshire Joan B. Beasley, Ph.D.
Humanity - conduct all activities with compassion, understanding, and kindness. Community - develop and maintain fellowship with others that share common attitudes, values, interests, and goals. Institute on Disability/UCED, University of New Hampshire Joan B. Beasley, Ph.D.
Fidelity – provide training and consultation to support the integrity of activities that make the START Model effective and directly impact the success of desired outcomes. Institute on Disability/UCED, University of New Hampshire Joan B. Beasley, Ph.D.
Institute on Disability/UCED, University of New Hampshire Joan B. Beasley, Ph.D.
Options to join the START Network Institute on Disability/UCED, University of New Hampshire Joan B. Beasley, Ph.D.
Program Based National Certified START Network on the START Elements of the START Model START Clinical Team (PLC) Provider Model Applies START evidence based X practices with fidelity to the START model Applies practices based on the START X (op8onal) model X X Some* Access to START trainings/curriculums X Use of the SIRS database (required) X X (op8onal) START coordinator certification Proficiency in the use or START X (op8onal) sanctioned tools (required) Research toward evidence based X practices X (op8onal) Quality assurance and training ongoing *As determined for the project Institute on Disability/UCED, University of New Hampshire Joan B. Beasley, Ph.D.
Program Based Elements of the START Therapeutic National Certified START Network on the START Supports/RC Model START Clinical Team (PLC) Provider Model The program meets the fidelity for START certified Resource Center/therapeutic X (optional) supports Services based on the START model X Training on and use of standardized, X (optional) START endorsed assessment tools Use of START endorsed admissions and X (optional) discharge protocols Therapeutic milieu provides therapeutic group activities, uses positive psychology X X X and strengths-based approaches Designated planned and emergency beds X (optional) Length of stay is short term (planned=avg. 3 days/month; emergency= X avg. of 2-3 weeks (less than 30 days) Connection to START clinical team services X (optional) Director of center is a certified START coordinator and is trained in providing X (optional) outreach to families and systems of support Institute on Disability/UCED, University of New Hampshire Joan B. Beasley, Ph.D.
Whatever option, there is a commitment to learning Institute on Disability/UCED, University of New Hampshire Joan B. Beasley, Ph.D.
Institute on Disability/UCED, University of New Hampshire Joan B. Beasley, Ph.D.
We perform best through our collective intelligence “As long as everyone got a chance to talk, the team did well. But if only one person or a small group spoke all the time, the collective intelligence declined” - NYT Magazine “The Work Issue” 2/28/16 Institute on Disability/UCED, University of New Hampshire Joan B. Beasley, Ph.D.
UNH/IOD Center for START Services: Building capacity • PLCs • Coaching • Technical Support • Certification ( coordinators and program) • National Online Training Series • Certification Course • Fidelity Guides • START Curricula • MH/IDD training lifespan • CETs • START National Training Institute Institute on Disability/UCED, University of New Hampshire Joan B. Beasley, Ph.D.
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