Policy

Illinois Policy Issues Impacting Services for People with Dual Diagnosis

Surveys and interviews with over 50 Illinois service providers, agency administrators, advocacy organization leaders, and other key informants identified several policy issues  and challenges impacting people with dual diagnosis which are described below. A recent presentation highlights and expands on some of these issues (This presentation is linked below).

• Provider workforce shortage due to low pay, high turnover, and large proportions of unfilled positions at programs serving the dual diagnosis population.

• Over-reliance on crisis services results in inefficient allocation of resources to a small sub-group of those needing treatment and support, and under-funding of community care.
• State agencies’ case records often lack historical information needed to identify, diagnose, and treat trauma among people with IDD.
• Over-use of polypharmacy and lack of coordination between prescribers working with people with dual diagnosis.
• Community mental health programs lack financial incentives, inadequate program structure, and clinical skills training to serve people with IDD. especially those without spoken language and those with lower cognitive abilities.
• Lack of inclusion of information about dual diagnosis in clinical courses taught in Illinois’ colleges and universities.
• Need for state to prioritize trauma informed treatment environments in IDD and mental health service programs.
• Need for a wide range of language translation services in service delivery settings across the state.  
• While providers generally report knowledge of culturally competent approaches, difficulty recruiting and hiring culturally diverse staff at both management and direct service levels impact the ability of community agencies to work with diverse individuals and families.
• Need for greater  adoption of evidence-based transition models for people exiting state operated developmental centers   to community programs.
• Inadequate discharge policies covering people with dual diagnosis exiting both state- operated developmental centers and community programs.
• Lack of step-down services for helping people transition between levels of care.
• Need for formal collaboration including regular, ongoing meetings between state agencies involved in serving people with IDD and mental health challenges.
• People with dual diagnosis reside in jails and prisons without treatment, especially in the southern part of the state.
• Lack of public hospitals with psychiatric units willing to accept patients with dual diagnosis.