Improvement in mental health outcomes and caregiver service experiences associated with the start program

Luther G. Kalb, Joan Beasley, Andrea Caoili, Ann Klein

Research output: Contribution to journalArticlepeer-review


This study examined outcomes from the Systemic, Therapeutic, Assessment, Resources, and Treatment (START) program, a community-based tertiary care model for individuals with intellectual and developmental disabilities and mental health needs. The sample included 111 START service users and their family caregivers, who were receiving START Clinical Team services, located in the Northeast and Southwest regions of the United States. Results from the analyses found a significant 1-year pre-post improvement in caregiver service experiences and mental health symptoms of the service user. A significant decrease in psychiatric hospitalizations and emergency department visits was also found (all p, .01). These data suggest that START holds promise in improving outcomes, for both the caregiver and service user, while reducing dependence on costly and restrictive hospital-based services.

Original languageEnglish (US)
Pages (from-to)25-34
Number of pages10
JournalAmerican journal on intellectual and developmental disabilities
Issue number1
StatePublished - Jan 2019


  • Developmental disability
  • Hospital
  • Intellectual disability
  • Mental health
  • Services

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Neuropsychology and Physiological Psychology
  • Developmental and Educational Psychology
  • Arts and Humanities (miscellaneous)
  • Clinical Neurology
  • Psychiatry and Mental health


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