Dual Diagnosis (ID/MH)

Students with a diagnosis of Intellectual Disability and mental health issues (ID/MH) will have the ID diagnosis throughout their lives, but they may experience MH issues periodically. When they are not experiencing MH issues, they have needs similar to students who have a single diagnosis of ID. However, if they are experiencing MH issues, then The Guild is likely an appropriate placement.

The Guild is a private, special education school dedicated to serving the needs of students who have ID – ranging from mild to severe. When students with a dual diagnosis are experiencing symptoms related to their mental health issue, they need not only services designed for individuals with ID, but also additional services to address their mental health needs.

One pathway into The Guild is as a step-down from a psychiatric hospitalization. For children, adolescents and young adults who have stabilized during an in-patient psychiatric stay, The Guild’s community-based program is often an appropriate setting. The schedule of 234 days per year of school and the consistency between school and student homes provide the structure that individuals with dual diagnoses need. There are a variety of mental health challenges experienced by Guild students, including but not limited to depression, anxiety, obsessive thoughts and compulsive behaviors, mood disorders, posttraumatic stress and bipolar disorder.

Thorough assessments are essential for individuals with the ID/MH dual diagnosis. Characteristics such as high levels of anxiety or strong resistance to change in daily routines may be manifestations of ID or of Autism Spectrum Disorder (ASD). Or, they may be symptoms of mental illness. Observations and assessments are used to identify when an individual has a single diagnosis of ID or ASD and when a dual diagnosis of ID/MH is warranted.

Students with a dual diagnosis of ID/MH are supported by a range of treatment approaches. In addition to talk therapies, such as Cognitive Behavioral Therapy adapted for youth with ID, The Guild offers Expressive Therapy, which uses the visual arts, music, drama and other creative endeavors as the treatment modality. Expressive Therapy is provided in group or individual sessions. Different group approaches have included drumming groups, song-writing groups and movie-making groups.

At The Guild, psychopharmacology is managed by two consulting psychiatrists, Dr. John Julian and Dr. Mark Hauser, who have dedicated their careers to serving individuals with the ID/MH diagnosis. A student’s multidisciplinary team, which includes parents or guardians and students themselves when appropriate, provides the treating psychiatrist with status updates. Parents and guardians who are unable to attend in person, participate via conference call. The student’s behavioral data is projected on a screen, serving as a focal point so that the discussion is data-informed.

The Guild is able to serve children, teens and young adults with dual diagnoses successfully due to our model of working as a multidisciplinary team to ensure the education and care of students and adults.