A Letter from YAI

YAI, one of New York State’s oldest and largest providers of support for people with intellectual and developmental disabilities (I/DD), will begin implementing START/CSIDD in OPWDD’s Region 2 in April. 


Systematic, Therapeutic, Assessment, Resources, and Treatment (START) is a comprehensive model of service support that optimizes independence, treatment, and community living for people with I/DD who also have behavioral health needs, START is known in New York as Crisis Services for Individuals with Intellectual and/or Developmental Disabilities (CSIDD). The START model was created by Dr. Joan B. Beasley and her team in 1988. Evidence-based and person-centered, START provides community-based crisis intervention for people with I/DD and co-occurring mental health needs. START uses positive psychology to help people build up community-based supports.

For more than six years, YAI has overseen START programs in the Bronx, Manhattan, and Queens, where it created linkage partnerships with key community stakeholders, provided training to more than 2,000 care managers, and built the capacity of service providers. The pilot was responsible for a pronounced decrease in the utilization of emergency interventions in New York City. YAI also oversees START programs in California and will soon be running a START program in Maryland.

In the 2002 U.S. Surgeon General’s Report on mental health disparities for people with I/DD, START was cited as a model program. In 2016 START was discussed as a best practice at a roundtable on the Promotion of Health Equity planned by the National Academy of Sciences Institute of Medicine.

START programs currently operate in 14 states and have network partners in four others, providing 24/7 crisis intervention support for children and adults. Filling in local service gaps and strengthening community supports and systems, START programs carefully track different data points to measure success. The holistic approach of the START model focuses on trauma-informed, positive psychology interventions and biopsychosocial evaluations. The approach is fundamental to all the positive quality of life measures outcomes that are achieved by START teams across the nation.

With a unique approach to community-based programming, YAI has been providing innovative services to people with I/DD for 65 years. Launched out of a small school in Brooklyn and initially staffed by co-founders Bert MacLeech and Pearl Maze MacLeech alone, their pilot program served just seven people. MacLeech envisioned a “total life adjustment approach, emphasizing personal growth, social responsibility, employment goals, and the development of independence for the individual.” At a time when institutional living was the norm for people with I/DD, this vision was nothing short of revolutionary. YAI’s person-first philosophy aligns with START’s vision, allowing for effective program implementation. Empowering the people we support to reach their goals remains at the heart of everything YAI does.

The YAI Region 2 team plans to have an active presence in Central NY, Sunmount/North Country, and Southern Tier/Broome. With an initial goal of building partnerships with community stakeholders, YAI is eager to present the START model. The agency is now recruiting for key clinical positions.

For more information on how to get involved with YAI’s Region 2 START program, please contact Ivy Lewis, program director, at ivy.lewis@yai.org.

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