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Health Care Advocacy

Dual Diagnosis

An Enhanced Family Support Crisis Handbook

How to cope when an adult loved one with an intellectual or developmental disability experiences complex mental health and/or behavioral issues? The purpose of this handbook is to inform and empower families and caregivers so that they can more effectively advocate for individuals with severe behavioral health and/or mental health conditions.

Crises are a Family Affair

Lucille Esralew, Ph.D. Clinical Administrator SCCAT & S-COPE, Trinitas Regional Medical Center

In a mental or behavioral health crisis, we all tend to focus on one identified individual.  However, I would like to suggest that this is a limited and not particularly helpful approach because crises affect all members of the family.

For the purpose of our discussion we will follow John, a hypothetical individual, age 24, who receives DDD services and who has an intellectual disability as well as a diagnosis of bipolar disorder. John's mother, Mrs. Smith, is John's primary caregiver and support person. According to our usual thinking and practice, if John has acted unsafely, resulting in his need for crisis services or hospitalization, all services leading up to, during and following hospitalization would focus on John.  Read more.

Please review the recordings and slides from our 2023 webinar series:

Exploring Mental Health and Behavioral Health Challenges in People with IDD

This 5-part webinar series examined dual diagnosis: co-occurring mental health and/or behavioral health conditions in persons with intellectual and developmental disabilities (IDD). Topics include diagnosis, treatment options, best practice, and more.

Webinar #1

Unpacking the Complexities of Dual Diagnosis (Mental Illness and Intellectual and Developmental Disability)

Although mental health concerns are not uncommon among individuals with IDD, they are difficult to diagnose and treat. This webinar will include considerations for the diagnosis and non-pharmacological treatment of mental health concerns for individuals with IDD and serve as an introduction to The Arc of NJ's series on dual diagnosis.

Lucille Esralew, Ph.D., NADD-CC
Senior Psychologist Supervisor and Clinical Lead of the Clinical Services Branch
Office of Statewide Clinical Services, California Department of Developmental Services

Recording   |  Slides

Webinar #2

Assessment of Behavior Change in Persons with Intellectual and Developmental Disabilities

Behavior has multiple causes, including mental health conditions, discomfort, grief, trauma, the environment, and other unmet needs. Accurate assessment is valuable to understanding mental health symptoms, as well other factors that may contribute to behavior change. This session will address how to recognize and evaluate behavior change in people with Intellectual and Developmental Disabilities (IDD) to identify appropriate treatment and support.

Melissa Cheplic, MPH, NADD-CC
Senior Training and Consultation Specialist
The Boggs Center on Developmental Disabilities
Rutgers Robert Wood Johnson Medical School

Recording   |   Slides

Webinar #3

The Impact of Physical Health Conditions on Mental Health in Individuals with IDD

In this webinar, you will learn about the impact physical health conditions may have on a person’s mental health status, and how physical health can often impact behavioral health challenges.  In many cases a physical problem is the direct cause of a mental health problem or a contributing factor. Research indicates that up to 40% of individuals with IDD who are referred for an inpatient psychiatric stay have an undiagnosed or under-treated medical problem that led to challenging behaviors and hospital admission. A multidisciplinary assessment is essential, and a model for integrating mental and behavioral health supports with primary healthcare will be presented.


Jennifer LeComte, DO
Medical Director, Rowan Virtua RISN Center

Wendy Aita, PhD
Co-director, Rowan Virtua RISN Center

Recording  |  Slides

Webinar #4

Positive Support Interventions for People with IDD/MI

Part 4 of The Arc of New Jersey's webinar series on dual-diagnosis (intellectual and developmental disabilities and mental illness) will focus on treatment modalities and more specifically on Positive Support Interventions.
By the end of this session, participants will be able to:
- define positive supports
- describe strategies to support people with IDD and MI
- define population health management and implications for support

Dan Baker, PhD, NADD-CC, CCE

Recording  |  Slides

Webinar #5

START Model Implementation and Outcomes

In Governor Murphy's proposed FY 24 State budget, funding has been allocated for implementation of the START Program in New Jersey. This webinar describes the START Model, an evidence-informed mental health crisis service for people with IDD, and outcomes associated with implementation in various locales.

PLEASE NOTE: We were not be able to record this session to share with non-attendees. However, a link to the slides is below.


Karen L. Weigle, PhD, Licensed Psychologist
Associate Director/Director of Program Development
National Center for START Services
Institute of Disability
University of New Hampshire