How Do Health Outcomes Compare in Adults with DD with and without Mental Health Problems

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How Do Health Outcomes Compare in Adults with DD
with and without Mental Health Problems?

• Susan M. Havercamp, Ph.D.
• University of North Carolina
• North Carolina Office on Disability and Health
• Karen Luken, TRS/CTRS
• North Carolina Office on Disability and Health
• AAMR 2004

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Health DD

• DD health is invisible to public health and
  ignored by DD service delivery
• Research suggests prevalence of health conditions
  is the same or higher
• Limitations in function due to problems with
  communication, physical fitness, and weight
• Healthcare access can be a challenge, especially
  in the community

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Health Mental Health

• Mental Health problems may look like physical
  illness and vice versa
• Poor physical health may worsen mental health
  problems (esp. anxiety and depression)
• Physical health problems may go undetected in
  persons with mental illness

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Health Indicators

• National Core Indicators is a Quality Management
  protocol for the DD service delivery system
• Coordinated nationally by Human Services Research
  Institute (HSRI)
• Standard instrument, interviewer training, and
  methodology
• Three sources of information self-report, proxy
  (informant), and case manager (file)

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DD Sample Selection

• Stratified random selection of individuals
  meeting inclusion criteria
• Adults (age 18) who receive services from the
  state division on developmental disabilities
• Invited to participate in interview (informed
  consent obtained by case manager)

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Health Indicator Items

• Many Items adapted from the BRFSS
• BRFSS methodology under-represents DD
• Special considerations in interviewing persons
  with DD
• Cloak of competence
• Acquiescence
• Memory impairment

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Physical Health is compared across two groups

• Adults with Developmental Disabilities without
  co-occurring Mental Health Problems (n675
  70.8)
• And
• Adults with Developmental Disabilities and Mental
  Health Problems (n341 29.2)

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Of persons with MH problems,
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Demographics
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Demographics, continued
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Health Indicators Content

• Health Risk Behaviors
• Overall Health Status Health Conditions
• Healthcare Access

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Health Risk Behaviors
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Mental Health Risk /Resilience
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Chronic Health Conditions
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Health Service Utilization
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Health Indicators Conclusions

• Adults with dual diagnosis are more likely to
  smoke cigarettes and be overweight or obese
  compared to adults with developmental
  disabilities without mental health problems.
• Both groups (MH and noMH) suffer extreme life
  stress and inadequate social support
• Adults with dual diagnosis were more likely to
  have diabetes and high blood pressure
• The MH group had surprisingly better access to
  healthcare services

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• Adults with developmental disabilities, and
  especially those with co-occurring mental health
  problems, are in need of health promotion and
  disease prevention initiatives

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For more information

• Contact
• Susan M. Havercamp, Ph.D.
• University of North Carolina
• CB 7255
• Chapel Hill, NC 27599-7255
• Tel. [phone]
• E-mail susan.havercamp_at_cdl.unc.edu
• OR
• Visit the HSRI website
• www.hsri.org/manage/core.html