Feature Issue on Addiction and IDD
Better Help Through DSPs and Peer Mentors
Staff of the Peer Mentoring Program present curriculum details and engage with community members during an outreach event.
Westside Regional Center is a private, nonprofit agency dedicated to serving children and adults with developmental disabilities living in the western area of Los Angeles County. As one of the 21 regional centers under the California Department of Developmental Services, Westside Regional Center provides assessment and determination of eligibility for services and early intervention services for at-risk infants and their families. In addition, the center provides lifelong individualized planning and service coordination, along with education and advocacy for the protection of legal, civil and service rights. Other services include developing and purchasing services according to each person’s Individual Program Plan.
Opportunities through Mental Health Services Act in partnership with the California Department of Developmental Disabilities
At Westside Regional Center, we also seek grant-funding opportunities to develop innovative services addressing the unmet needs of our community. For example, we have implemented multiple projects focused on recognizing and addressing the needs of individuals with intellectual and developmental disabilities (IDD) and mental health conditions, also known as dual diagnosis. Prevalence data is mixed, but our experience in the intersection of developmental disabilities and mental health issues reinforces the notion that a concerning number of people experience a dual diagnosis, which is often compounded by stigma, barriers to treatment, and an unrecognized need for accommodations. Many people who develop substance use disorders also have mental health conditions, and vice versa. Those supporting people with dual diagnosis and substance use disorders also face challenges. Among those supporting this population are direct service providers (DSPs) who work directly with people with IDD by assisting them to become independent and integrated into their community. A local survey found that DSPs emphasized the need for additional training to improve their skills in supporting the people they work with who have, or are at risk for, dual diagnosis and substance use disorders. Survey results also highlighted the lack of access to the interdisciplinary services in their communities for supporting this population. These findings led us to the development of our newest collaborative project, the Substance Use Delivery Expansion Project . The purpose of this project is to improve substance use disorder services for individuals with intellectual and developmental disabilities and/or mental health concerns. These initiatives have been made possible through funding from the Mental Health Services Act (MHSA) in partnership with the California Department of Developmental Services.
Supports for people with developmental disabilities and substance use disorders
Supporting people with IDD who also have (or are at risk of having) mental health and substance use disorders requires a multi-modal approach, such as peer support programs and provider training. Peer support programs can increase self-efficacy and belonging and improve self-confidence. Moreover, DSPs need to understand both the emotional and neurological needs of the individuals they work with and differentiate behaviors associated with IDD and those associated with substance use disorders to provide the most appropriate level of support. In our new project, we have incorporated a framework of those concepts implemented previously by Alta California Regional Center’s MHSA Substance Abuse Reduction Training Project .
Development of new resources for our community
Westside Regional Center has partnered with our neighboring regional center, the Frank D. Lanterman Regional Center, to lead the Substance Use Delivery Expansion Project. In this project, we are developing two programs: 1) the E-learning Certification Program, and 2) the Peer Mentoring Program.
The E-learning Certification Program, which will launch in December 2024, aims to increase the capacity of DSPs working with people with intellectual and developmental disabilities dually diagnosed with mental health and substance use disorders. The training modules will cover:
- Understanding the People You Support
- Risks, Impacts, and Recognizing the Signs of Substance Use Disorder,
- Navigating Systems of Care for Substance Use and Mental Health Treatment,
- Cultivating the Mindset for Supporting People with Accessing Treatment,
- and Motivational Interviewing and Practical Skills.
The Peer Mentoring Program provides training and support to adults with IDD in substance use recovery, enabling them to serve as peer mentors for other participants in recovery. Through education on substance abuse treatment and prevention, participants will be equipped to mentor their peers at weekly group meetings and monthly sober outings. The program is set to begin in the summer of 2024, and is currently recruiting mentors to join a supportive community focused on sober and substance free-living. Interested participants using supports from regional centers are welcome to reach out to the authors to be connected to the program or visit our project’s website for more information.
To guide the development of the E-Learning Certification and Peer Mentoring Program, we have surveyed the local DSP community. We had two goals: to better understand both their needs and the scope of substance use disorders among people with intellectual and developmental disabilities. Almost 150 service providers reported that more than half the people they support have co-occurring mental health disorders, and that nearly a quarter of this population could benefit from substance use interventions. Overall, almost half of the service providers reported lacking sufficient knowledge about mental health disorders, and nearly 70% considered themselves to have limited to no knowledge about substance use disorders.
In addition to engaging the local service provider community, we have also conducted extensive literature reviews to identify evidence-based practices for service providers to support individuals with intellectual and developmental disabilities and navigate systems of care for this population. Specifically, this research included prevalence studies on substance use among individuals with intellectual and developmental disabilities, as well as intervention studies highlighting approaches to care and key skills and tools for supporting the population with accessing treatment. To inform our e-learning program’s curriculum, we have incorporated our findings from our literature review and consulted with subject matter experts in fields of mental health, developmental disabilities, and motivational interviewing. We also received feedback and support from a multi-agency Grant Advisory Council formed at the start of this project as an ongoing collaborative process. Council meetings are attended by representatives from local agencies supporting people with mental health conditions, substance use disorders, and developmental disabilities.
Measuring success
To measure success, we will continue conducting literature reviews for the most current empirically validated studies to guide the project. We will also systematically monitor participant outcomes and fidelity of implementation. To measure the success of our E-learning Certification Program, we will collect pre-test knowledge data among learners prior to taking the program and compare it with post-test knowledge data after completion of the program. Completion of all course modules, satisfaction with the program, and/or knowledge gains of at least 20% will be considered a success.
To evaluate the Peer Mentoring Program, we will collect quantitative and qualitative data after program completion that measures the percentage increases in self-efficacy, social connectedness, and self-confidence from participants’ self-reported baselines. Participants will also self-report any changes in their knowledge about substance use, harm reduction strategies, and access to recovery support services across the duration of their engagement in the program. In addition, we will track engagement in local recovery group meetings or events, attendance at peer group activities, demonstration of learned skills, and meeting personalized goals. Project staff will engage participants in monthly to quarterly interviews to attain qualitative insights related to their overall satisfaction with the program, satisfaction with their mentor/mentee, and factors that may impact their ability to continue in the program.
The Substance Use Delivery Expansion Project aims to improve substance use disorder services for individuals with intellectual and developmental disabilities through peer support and training for DSPs. By continuing to innovate, collaborate, and rigorously evaluate our initiatives, Westside Regional Center remains committed to ensuring that individuals with developmental disabilities and co-occurring conditions receive comprehensive support to lead fulfilling lives.