Service Delivery

Organizational Supports to Promote the Community Integration of People With Dual Diagnosis.

Friedman (2021) · Intellectual and developmental disabilities 2021
★ The Verdict

Tailor agency rules on guardianship, communication, and housing and adults with IDD plus mental illness get more community life.

✓ Read this if BCBAs who help adults with dual diagnosis in day or residential programs.
✗ Skip if Clinicians who only run brief outpatient clinics.

01Research in Context

01

What this study did

Friedman (2021) looked at adults who have both intellectual disability and a mental-health diagnosis.

The team asked: do tailor-made agency supports help these adults join everyday community life?

They tracked real-world moves like choosing where to live, using public places, and picking jobs.

02

What they found

Adults got more community ties when agencies shaped supports around three things.

Those things were guardianship rules, how the person talks, and where the person lives.

When all three matched the person, integration went up.

03

How this fits with other research

Pettingell et al. (2022) widen the lens. They say treat people as full citizens first, then build programs. Carli shows one way to do it.

Matson et al. (2004) prove one person can move from a ward to a paid job with a simple DRA-DRO plan. Carli scales that idea to the whole agency.

Perel (1992) tried early individualized plans during a big move out of a state hospital. Carli updates the playbook for today’s dual-diagnosis services.

04

Why it matters

You can copy the three levers tomorrow. Check if guardianship limits outings, if communication aids ride the bus, and if housing rules block neighbors. Tweak one, track community days, and watch inclusion grow.

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→ Action — try this Monday

Open one client’s file, list any guardianship, housing, or communication barrier, and change one agency rule this week.

02At a glance

Intervention
not applicable
Design
other
Sample size
533
Population
intellectual disability, mixed clinical
Finding
positive

03Original abstract

One of the most common reasons people with intellectual and developmental disabilities (IDD) return to institutions is because of maladaptive behaviors. This study's aim was to examine the impact organizational supports can have on the community outcomes of people with dual diagnosis-those with IDD and psychiatric disabilities. We analyzed secondary Personal Outcome Measures interview data from 533 people with dual diagnosis. Findings revealed people with dual diagnosis were significantly more likely to have community outcomes present when they received individualized organizational supports. In addition, we found a number of disparities in organizational supports, including related to guardianship, communication method, and residence type. A more robust service system is necessary to ensure people with dual diagnosis are integrated into their communities.

Intellectual and developmental disabilities, 2021 · doi:10.1352/1934-9556-59.2.101