Behavior Supports

Behavior is communication.

• A child with Down syndrome was running out of the classroom before her team learned how to give her more flexibility in class.
• A doctor realizes an adult with autism is lashing out because of a urinary tract infection.
• A mother learns that medication interactions were causing increased agitation for her daughter with multiple disabilities.
• A family struggles to balance safety with independence for a loved one with Alzheimer’s.
• An adult with an intellectual disability and a mental health diagnosis is in crisis because of a lack of mental healthcare providers to meet his needs.
• Family members are worried about the risky relationship choices of a young woman with an intellectual disability.

We at the Council on Developmental Disabilities hear stories like this nearly every day. The stories cross all age groups and demographics. They tell the bigger story of our disability community’s struggles with behavioral health.

Many programs within our disability system are testing solutions. This gives us hope that we will find answers. But struggling people need solutions now. Finding those solutions can feel nearly impossible. We hope this page will help. We have created one place for clear, reliable information and resources about behavioral health for Tennesseans with intellectual and developmental disabilities.

Our Council will also keep close track of ongoing work on this topic. We will be at the table to help connect dots and build bridges so everyone is working together on real solutions. We will be thinking about a vision for what we want the system to provide. That vision will be rooted in our Developmental Disabilities Act values of self-determination, inclusion, and independence for all people with disabilities.

We want your feedback about your experiences while we work on this issue. Email us at Tnddc@tn.gov.

What do we mean by “behavioral health”?

The American Medical Association says behavioral health means the same thing as mental health. We think of behavioral health as related but a little different from mental health. Here is the definition we use. It talks about the unmet needs that a person’s behavior is communicating:

• Behavioral health is related to behavior, or the decisions that people make and the actions they take.
• It’s about how someone’s behaviors impact their mental and physical health AND how their mental and physical health impacts their behaviors.
• Improving behavioral health may include mental health care in order to address the underlying causes of the unhealthy behaviors, since they are often a result of some other issue.
• Improving behavioral health may also include other kinds of support that help the person build a routine of healthy self-care, both mental and physical.
• This page focuses on resources for people with disabilities, but we ALL need support for our behavioral health at times. If you are a caregiver, managing stress and practicing self-care has a significant impact on your ability to care for others, including those with disabilities. Supporting behavioral health for people with disabilities can include finding the right help for their caregivers and family members too.

Our Council resources and stories

A checklist for healthy behavior

Read about how this checklist was first created by our Chief Public Information officer, Jolene Sharp, who is also the parent of two children with disabilities, from our Dec. 2022 issue of Breaking Ground magazine ("Introducing a New Tool for Behavioral Health: Behavior Support Checklist")

One family's story with finding the right supports for healthy behavior

Jennifer Coleman, a former member of our Council, lives in Paris, TN. She shares in the embedded video below ("Coleman Family Story"; 2 minutes 30 sec.) how her family found behavioral supports and other needed services for her son.  "Around age 3, Tyler started having some really serious behavioral issues that made it very hard for our family. In 2019, we were finally approved for the ECF CHOICES program. They didn't just hand over the answers to me, but it was like a door leading to some pieces that were very valuable. I would recommend seeking out the program. Ask lots of questions. It's a slow process, but there is light at the end of the tunnel."   Learn more or apply for Employment and Community First CHOICES.

Hear more of Jennifer's story about finding the right kind of help for her son in this recorded video from the Clinical Consultation Network: "Tyler's Transformation with LifeConnect Health" (57 mins.)

Free help with behavior supports in schools

The Tennessee Technical Assistance Network (TN-TAN) is a program from the Tennessee Department of Education that offers free help to schools and families to support students with disabilities, ages 3-22.  Read more about how TN-TAN is helping schools and families in our e-news article here.

Know of a school or family that needs help?

We worked this year, especially during the state legislative session, to inform Tennesseans and policymakers about resources for schools through TN-TAN (TN Technical Assistance Network).  Use the one-pager below to inform others in your community about TN-TAN. If you hear about schools or families who are struggling to manage behavior issues for students with disabilities, tell them about TN-TAN.

Plain language information about behavior supports for Tennesseans with disabilities (Council e-news articles)

• Program Spotlight: TN-TAN (TN Technical Assistance Network, a project of the TN Dept. of Education)
• Program Spotlight: Behavioral Health Safety Net (TN Dept. of Mental Health and Substance Abuse Services)
• Program Spotlight: Crisis help through TN START (TN Dept. of Intellectual and Developmental Disabilities)

Other TN resources to explore

State programs to help Tennesseans with disabilities with behavioral health

• Employment and Community First CHOICES is a program that provides long-term services and supports to people with intellectual and developmental disabilities of all ages. There are several benefit "groups" that people may qualify for. Groups 7 and 8 are for helping people with disabilities who have behavioral health challenges. Read more and fill out a self-referral form here.
• Katie Beckett is a program that provides help for kids with disabilities ages 18 and under and their families who make too much money to qualify for Medicaid. Kids who need significant support for their behavioral health may qualify for Katie Beckett. Read more and fill out a self-referral here.
• Tennessee START Assessment & Stabilization Teams (TN START AST) are a statewide resource for people with intellectual and developmental disabilities who have complex behavioral or mental health needs. Right now, TN-START helps people who already get any kind of Medicaid disability program. Read more and fill out a self-referral here. (Watch the video below to see how TN-START is helping Jadyne, the daughter of one of our 2022 Partners in Policymaking graduates, Jackie Kancir.)

You can apply online at any time for any of the programs listed above. Each program's webpage will also list phone numbers you can call if you have questions or need help applying.

Help your healthcare provider serve patients with disabilities

• IDD (Intellectual/Developmental Disabilities) Toolkit - Behavioral and Mental Health issues
• TN Department of Intellectual and Developmental Disabilities Clinical Services Video Learning series
• Emergency Room Stabilitzation Protocol ("Dos and Don'ts for Caring for Patients with Intellectual and Developmental Disabilities")
  • Read more about why and how this was created, starting with the experiences of one of our Partners in Policymaking scholars coming to the Council for help in "Jackie's Story" in our 2023 annual report. You can also read related news stories: "Rare genetic disorder case inspires new ER protocol, emphasizing empathy and respect" (WZTV; includes interview with Council Executive Director Lauren Pearcy) and "After daughter's rare diagnosis, mom works to improve hospital responses" (News Ch. 5).

Training on behavioral health and disabilities

• The Clinical Consultation Network (CCN) is a group led by the TN Department of Intellectual and Developmental Disabilities. It includes many kinds of professionals who work with people with developmental disabilities. They meet virtually every week and their meetings are open to anyone (access information is on their webpage). They record and share the presentations about all kinds of disability topics, including behavioral health and psychological care for people with disabilities. Explore their video library here. 
  • Hear our former Council member Jennifer Coleman tell her son Tyler's story of getting the right kind of behavioral health supports: "Tyler's Transformation."
• Request a training from TN-START for your team or agency - The TN START Assessment & Stabilization Teams are a statewide resource for people with intellectual and developmental disabilities who have complex behavioral or mental health needs. They offer free trainings that can be conducted virtually or in-person for all audiences.  The trainings are most appropriate for those who work within or support the mental health, emergency services, and intellectual/developmental disability (I/DD) systems. Custom trainings about people with I/DD and co-occurring behavioral health needs are also available upon request.
  
• TRIAD (Treatment and Research Institute for Autism Spectrum Disorders) at Vanderbilt Kennedy Center provides help and training to families, caregivers, educators, service providers and other professionals around lots of different topics related to autism, including behavioral health. They are the experts that contract with TN-TAN, the free technical assistance network for schools mentioned above, that help schools support students who have disabilities and challenging behaviors. Explore their website and sign up for their newsletters to learn more.
• TN-NADD (TN chapter of the National Association of the Dually Diagnosed) is a nonprofit membership association for professionals, providers, and families of people who have developmental disabilities and mental health needs. They host an annual conference and other events about behavioral health and disability.

National resources

• 2023 "Discipline Discussion" blog series from the U.S. Dept. of Education's Office of Special Education and Rehabilitative Services on school discipline and behavior for students with disabilities
• Understanding autism, aggression, and self-injury: medical approaches and best support practices (Thinking Person’s Guide to Autism; By Clarissa Kripke, MD, FAAFP, 2016)
• The Link Center - Bridging the I/DD and Mental Health Systems (Administration for Community Living initiative)
• National Center for START Services
• NADD - the national association for the dually diagnosed (people with intellectual/developmental disabilities AND mental health diagnoses)