Introduction
This is the first installment of a monthly initiative that will cover a variety of healthcare topics related to developmental disabilities. Our goal is to provide reliable information around a variety of relevant health topics to our employees, the people we support and their support networks. Links to the original publications and resources used to create these resources will be provided within the article.
If you have any questions, concerns or would like to add something to the discussion you can reach out to the Healthcare Strategies Manager at gcruncian@christian-horizons.org.
What is Dual Diagnosis?
When completing a search for Dual Diagnosis it can quickly become confusing. The term Dual Diagnosis can have a different meaning depending on where the information comes from. Notably in the United States, where most publications are based, a Dual Diagnosis refers to a diagnosis of a mental illness in addition to alcohol or substance abuse.
For our purposes we will focus on the Canadian and Health Care Access Research and Developmental Disabilities (H-CARDD) definition of dual diagnosis which is a Developmental Disability in addition to a Mental illness and/or addictions. The slide below outlines the notable differences:
To see the original presentation this slide came from click here: Source
How Common is dual diagnosis?
“People with developmental disabilities are at an increased risk for developing mental health problems throughout their lives. Large-scale studies indicate that people with developmental disabilities are three to six times more likely to develop a mental health disorder than other people.” (Source)
While the exact rate of dual diagnosis can vary depending on whether or not there is a diagnosed mental health disorder, it is clear that serious mental health problems exist for many people with a developmental disability.
Recognizing Dual Diagnosis
Mental health concerns can present in unique ways for people who have a developmental disability. Further, the presentation of mental health problems can change over time. A number of biological, psychological and social factors increase the likelihood of a person with a developmental disability diagnosis also having mental health problems.
When determining if a person with a developmental disability has a mental health illness Health Professionals will first look to rule out other causes including biological and social factors. They will use a decision tree that includes asking:
Treatment
People with dual diagnosis are some of the most vulnerable in society and in the healthcare system. For many, receiving the care they need is a long and complex process. Five principles should guide treatment and support for people with a dual diagnosis:
- People with a dual diagnosis are people first. Keep in mind their strengths and not only their difficulties.
- Mental health problems are under-identified in people with Developmental Disabilities
- Mental health problems for people with developmental disabilities are complex but understandable.
- Mental health problems for people with developmental disabilities are complex but can respond to care and treatment.
- People with dual diagnosis require a holistic approach to their care that goes beyond separate interventions for mental health issues and developmental disability.
Crisis and Emergency
Even with the best planning and unlimited supports crisis and emergency can occur with little or no warning.
Crisis: Serious deterioration of a person’s ability to cope.
Emergency: An immediate danger that the person will harm either themselves or someone else.
Having detailed care plans for the people we support that outline what to do when they are in a period of crisis or emergency will help ensure the best possible outcomes when these situations occur. For more detailed ideas on how to respond in times of Crisis or Emergency for the people supported at Christian Horizons you can see the section on Crisis and Emergency here. In the event that a crisis or emergency plan does not exists employees should not hesitate to call emergency services (911) if they feel the need is there.
Closing Thoughts
With the definition of Dual Diagnosis differing in Canada from the United States it becomes doubly important to ensure that any resources referencing Dual Diagnosis are accurate to our needs. More information and resources on supporting people with dual diagnosis can be found here:
Dr. Yona Lunsky and Dr. Jonathan Weiss, Dual Diagnosis An Information Guide – (Source)
The Centre for Addiction and Mental Health (CAMH), Dual Diagnosis: Resources (Source)
Dr. Elizabeth Lin, Weaving together addictions and developmental disabilities: The “other” dual diagnosis. (Source)