Community Capacity to Provide Mental/Behavioral Health Services for People With IDD Transitioning From State-Operated Developmental Centers.
Small community homes plus behavioral health coaching keep ex-institutional clients with IDD from boomeranging back.
01Research in Context
What this study did
Lulinski et al. (2021) sent surveys to 315 community agencies. These agencies serve adults with IDD who just left large state centers.
The team asked: who comes back to the institution, and why? They tracked IQ, mental health labels, length of stay, home size, and whether the agency got behavioral health coaching.
What they found
Kids and adults under 35, higher IQ, a psych diagnosis, or a short prior stay were most likely to bounce back.
Living in a bigger group home and having no behavioral health coach also raised the risk of return.
How this fits with other research
Navas et al. (2025) followed similar adults for two years. Real choice in daily life—not just living in the community—drove huge quality-of-life gains. Amie’s data add the warning: without small homes and mental health help, those same people may re-enter.
Amaral et al. (2019) tested START, a community wrap-around program. Psych hospital days dropped 70 %. Amie’s survey shows any agency can copy this by simply buying behavioral health technical assistance.
Fortney et al. (2021) found rural adults with IDD get half the preventive care of city peers. Amie’s paper hints the same gap may push rural clients back to institutions, because fewer local agencies offer mental health coaching.
Why it matters
If you place a client in a four-bed home and link the team to a BCBA for mental health coaching, you cut the re-institution odds. Push for small settings and write TA into the ISP. It is the cheapest, fastest lever you have on Monday.
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02At a glance
03Original abstract
The study's aim was to explore the capacity of community-based providers of residential supports and services to support people with intellectual and developmental disabilities who transitioned out of state-operated institutions into community-based settings. Receiving agency survey results from 65 agencies and individual-level variables of 2,499 people who had transitioned from an institution to a community-based setting indicated that people who returned to an institution post-transition tended to be younger, have a higher IQ score, were more likely to have a psychiatric diagnosis, tended to have shorter previous lengths of stay at an institution, transitioned to larger settings, and received services from an agency receiving behavioral health technical assistance as compared to those who remained in their transition settings.
Intellectual and developmental disabilities, 2021 · doi:10.1352/1934-9556-59.3.224