Evaluation of the START Plan, a Mental Health Crisis Risk Rating Scale for People With Intellectual and Developmental Disabilities
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Authors
Caoili, Andrea
Date
2024-05
Type
Dissertation
Language
en
Keywords
Alternative Title
Abstract
AN ABSTRACT OF THE DISSERTATION OF
Andrea Caoili for the degree of Doctor of Education, Learning, Leadership, and Community
Presented on May 13, 2024
Title: Evaluation of the START Plan, a Mental Health Crisis Risk Rating Scale for People With
Intellectual and Developmental Disabilities
Abstract approved:
______________________________________________________________________________
Scott Mantie, PhD, Dissertation Committee Chair
People with intellectual and developmental disabilities (IDD) are at increased risk of
having mental health conditions compared to the general population. This risk, coupled with
disparities in access to community-based mental health services results in higher crisis service
utilization. There are few assessment instruments that consider the ecological context of mental
health crises experienced by people with IDD. This observational, cross-sectional study takes
place within the START (Systemic, Therapeutic, Assessment, Resources, and Treatment)
program, a crisis prevention and intervention service for people with IDD and mental health
conditions (IDD-MH). The study investigates the application of the START Plan, one of the
primary assessment instruments used by START programs nationwide. The START Plan fills a
unique gap by incorporating ecological factors that may contribute to crisis service use among
this population. An existing data set (N = 6,397) from the START Information Reporting System
was used. Chi-squared and a one-way analysis of variance (ANOVA) statistical tests were
utilized to evaluate the relationship between START Plan scores and (a) reported
sociodemographic characteristics (race, ethnicity, age, gender, living situation, and mental health
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diagnosis), (b) START crisis contacts, and (c) scores on the Aberrant Behavior Checklist.
Findings indicate a relationship between mental health instability and age, race, living situation,
and number of psychiatric diagnoses. This study also found the START Plan to have strong
predictive and construct validity, indicating the potential for application of the START Plan
across mental health crisis services designed for people with IDD.