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Community Clinic Association of Los Angeles County

The Achievable Foundation: Care Models for Intellectual and Developmental Disabilities

The Achievable FoundationThe number of individuals with intellectual and developmental disabilities (I/DD) such as autism, intellectual disability, cerebral palsy, epilepsy and Down syndrome has increased dramatically in the past decade; these individuals are thought to now make up 17 percent of the U.S. population. People living with I/DD face significant communication, behavioral, mobility and comprehension challenges, and very often suffer from serious health and mental health issues. This population typically requires extensive behavioral, psychiatric and physical services and supports throughout their lifetimes, yet they are often overlooked and underserved.

Patient at The Achievable Foundation
Patient at The Achievable Foundation

Research has shown that individuals with I/DD experience 2-3 times the rate of mental illness as the general population, in fact approximately 30-35 percent of adults with I/DD also have mental health conditions. Just as concerning is the rate of psychiatric disorders among children and youth with I/DD. Studies have shown that up to 70 percent of children and youth with autism experience psychiatric disorders, and over 40 percent of these children have two or more psychiatric diagnoses. These are documented rates; it is likely that the reality is far worse, due to the tendency of providers to overlook psychiatric symptoms in individuals with I/DD and/or misattribute them to a disability.

 

Despite this high incidence of mental health issues and a critical need for services, individuals with I/DD rarely receive the mental health care they need, especially therapy services. These patients frequently encounter barriers to appropriate care, as clinicians trained to treat both I/DD and mental illness are rare. Behavioral, communication or comprehension limitations make patients with I/DD more complicated to treat. Many of these individuals are nonverbal, have difficulty explaining their symptoms, and/or cannot adequately comprehend or adhere to traditional treatment plans. Finally, therapy with these patients often requires lengthy consultations and the coordination of complex physical health issues with a variety of providers for which clinicians are not adequately compensated.
Without adequate treatment, individuals with I/DD are put at high risk for losing their independence, as well as for psychiatric hospitalization, homelessness, victimization, or avoidable incarceration.

Doctor seeing patients at The Achievable Foundation
Doctor seeing patients at The Achievable Foundation

The complex needs of this growing population (individuals with both I/DD and mental health issues) requires the development of a healthcare workforce properly trained to provide comprehensive and compassionate treatment. The Achievable Foundation (Achievable), in collaboration with The Chicago School of Professional Psychology has implemented an innovative, community-based training program to develop clinicians and leaders in the field of clinical psychology for individuals with I/DD. Achievable is a nonprofit organization founded in 1996 with the mission of significantly improving the quality of life for individuals with I/DD and their families, by providing supports to help them live independent, productive and healthy lives. In 2013, Achievable launched a first-of-its-kind federally qualified health center (FQHC) with services specifically designed to address the unmet healthcare needs of individuals with I/DD and their families. Achievable focuses on providing comprehensive primary care, integrated with mental health care, to address whole-person health and well-being.

To enhance its integrated model of care, Achievable began a landmark collaboration in the Fall of 2015 with The Chicago School of Professional Psychology, the leading nonprofit university for psychology and the behavioral science fields since 1979. The Chicago School of Professional Psychology has developed its highly successful “engaged professional model” of education which focuses equally on academic learning and hands-on training, while providing critically needed mental health services to at-risk and underserved populations and communities. This uniquely balanced model creates the best educated and most highly qualified practitioners today, who develop the compassion and experience to become thought leaders and agents of positive change tomorrow.

Chicago School of Professional Psychology PhD students Grace Hamilton and Sonaly Silva conferring on a case.
Chicago School of Professional Psychology PhD students Grace Hamilton and Sonaly Silva conferring on a case.

This groundbreaking community partnership provides a once in a lifetime opportunity for doctoral students in the field of clinical psychology to complete a 9 to 12-month advanced practicum at the Achievable Health Center. These Ph.D program students learn to provide comprehensive therapy and treatment for the I/DD population as part of an interdisciplinary team of providers (a clinical psychologist supervisor, psychiatrist, physician, nurse and care coordinator). This collaborative and fully integrated health care approach has created a robust training program to strengthen and grow a highly qualified workforce (addressing the unique needs of a drastically underserved population), while at the same time providing individual, group and family psychotherapy services directly to the population in need. The training/service model developed from this partnership has now proven to be successful in meeting a previously un-met need. In addition, the model can be replicated and/or adapted into various community care settings, to further expand the workforce and improve care for those with I/DD, mental illness, and especially the co-occurrence of both.

Front desk at The Achievable Foundation, located in Culver City, CA.
Front desk at The Achievable Foundation, located in Culver City, CA.