Improvements could be made to better serve people in Missouri who battle a dual diagnosis of a developmental disability and a mental illness, a state official said.

Dual diagnosis examples could be someone who has autism and schizophrenia or depression and cerebral palsy.

Improving communication between the developmental disabilities division and the behavioral health division is key to enhancing the level of service that those with dual conditions receive, said Valerie Huhn.

She is the director of the Division of Developmental Disabilities with the Missouri Department of Mental Health and spoke to The Missourian last week about the dual diagnosis issue.

Last year, the two divisions served 1,200 of the same clients.

Enhancing the quality of care for people who battle dual conditions is a national issue, and some improvements could be made in Missouri now without budget action, she said.

Services Lacking

Some services to better assist people with a dual diagnosis in Missouri are lacking. Short-term respite care for adults and children with a dual diagnosis is needed to give families a place to put them during difficult times.

“These can be very disruptive moments, and so you want to be able to try and get them back into an environment that they’re used to,” Huhn said. “A lot of times they either end up in the emergency room or they can end up in jail. We know that is not where they belong, and so one of the things we think we can build is a respite option . . .”

While the person is in respite, options such as counseling could be explored to determine what needs to be done to hopefully transition the person back home.

Likewise, a longer-term intensive residential option for those with a dual diagnosis is also lacking, Huhn said.

There are residential options for people who have either a mental illness or developmental disability, but not for those who have both conditions, she said.


Mental health and developmental disabilities professionals recently helped formulate a list of strategies to more effectively serve people with the dual conditions. Locally, Tom Sinclair, the executive director of Developmental Services of Franklin County, took part in the group.

The state developmental disabilities division needs help when it comes to crisis intervention, but the behavioral health side does a pretty good job in this respect, said Huhn.

If people served by the developmental disabilities division are in crisis, such as being suicidal or threatening others, they’re often taken to the emergency room or the police are called, Huhn said.

But on the behavioral health side there are crisis intervention teams, which are really only trained on mental illness and not developmental disabilities or dual diagnosis, she added.

“But we (developmental disabilities division) think we could take advantage of those teams and kind of develop some sort of training protocols for them to follow so they could help us with this specific population,” Huhn said.

This is another area where an improvement could possibly be made without budget action, she said.

A “gap analysis” identified areas where more work is needed. It showed that communication between the division of developmental disabilities and behavioral health could be improved. Each side could train the other on its practices, and this is another strategy that could possibly be done without budget action, she noted.

One goal is to have a professional in the community mental health centers who is oriented to developmental disabilities, Huhn said.

A national organization could come to Missouri and provide training on best practices and treatment of dual diagnosis.