Rutgers Institute for Health, Health Care Policy and Aging Research, Rutgers University, New Brunswick, and Department of Psychiatry, Rutgers Robert Wood Johnson Medical School, Piscataway, New Jersey (Stone); Departments of Health Policy and Management (Jopson, McCourt) and Health, Behavior, and Society (German), Johns Hopkins University Bloomberg School of Public Health, Baltimore; Department of Population Health Sciences, Division of Health Policy and Economics, Weill Cornell Medicine, New York City (McGinty).
Psychiatr Serv. 2024 Aug 1;75(8):770-777. doi: 10.1176/appi.ps.20230451. Epub 2024 May 21.
The authors aimed to identify barriers to and strategies for supporting coordination between state agencies for intellectual and developmental disability (IDD) or mental health to meet the mental health needs of people with co-occurring IDD and mental health conditions.
Forty-nine employees of state agencies as well as advocacy and service delivery organizations across 11 U.S. states with separate IDD and mental health agencies were interviewed between April 2022 and April 2023. Data were analyzed with a thematic analysis approach.
Interviewees reported that relationships between the IDD and mental health agencies have elements of both competition and coordination and that coordination primarily takes place in response to crisis events. Barriers to interagency coordination included a narrow focus on the populations targeted by each agency, within-state variation in agency structures, and a lack of knowledge about co-occurring IDD and mental health conditions. Interviewees also described both administrative (e.g., memorandums of understanding) and agency culture (e.g., focusing on whole-person care) strategies that are or could be used to improve coordination to provide mental health services for people with both IDD and a mental health condition.
Strategies that support state agencies in moving away from crisis response toward a focus on whole-person care should be prioritized to support coordination of mental health services for individuals with co-occurring IDD and mental health conditions.
作者旨在确定支持州机构之间协调的障碍和策略，以满足同时患有智力和发育障碍（ID）和精神健康状况的人的精神健康需求。
2022 年 4 月至 2023 年 4 月，对美国 11 个州的州机构以及宣传和服务提供组织的 49 名员工进行了采访。采用主题分析方法对数据进行分析。
受访者报告称，ID 和精神卫生机构之间的关系既有竞争又有协调的元素，协调主要是针对危机事件发生的。机构间协调的障碍包括每个机构关注的人群范围狭窄、机构结构的州内差异以及对同时患有 ID 和精神健康状况的认识不足。受访者还描述了可用于改善协调以提供同时患有 ID 和精神健康状况的人的精神卫生服务的行政（例如，谅解备忘录）和机构文化（例如，关注整体护理）策略。
应优先考虑支持州机构从危机应对转向关注整体护理的策略，以支持同时患有 ID 和精神健康状况的个人的精神卫生服务协调。
