Project Janus is a not-for-profit corporation whose purpose is to support the most appropriate level of preventative care, treatment and crisis intervention services for constituents affected by a dual diagnosis of intellectual disability and mental illness (ID/MH). It is also committed to providing supportive education and services for members of their extended families. Project Janus seeks to accomplish these purposes by supporting programs and service structures designed to assist individuals with a dual diagnosis of ID/MH to live more successful and rewarding lives.

Located in San Angelo, Texas, Project Janus, Inc. was created in response to community recognition that individuals with a dual diagnosis of ID/MH were unable to access many of the services they required within the sprawling, sparsely populated area of West Texas where they currently reside. Together, representatives from the MHMR Service Center for the Concho Valley, San Angelo State Supported Living Facility, area law enforcement, public schools and local institutions of higher education, area health care facilities, the San Angelo Chamber of Commerce and private providers of ID/MH services brainstormed as to how to better serve this special population in our area. From these brainstorming sessions, Project Janus, Inc. was formed. The name of the organization was chosen to reflect the Roman god Janus, who could look in two directions at the same time, even as those who provide services to individuals with a dual diagnosis of ID/MH must look in two directions at the same time to provide effective treatment supports and services.

The demand for behavioral and psychiatric services for adults and adolescents with the dual diagnosis of ID/MH is increasing both in the state of Texas and nationwide. National surveys estimate that 20-30% of persons with an intellectual disability also have a co-existing psychiatric disorder. Historically, this population has been greatly under-served for a variety of reasons including inaccurate diagnoses, ineffective treatment, and staff who lack training in strategies specific to individuals with a dual diagnosis of ID/MH. Individuals with a dual diagnosis of ID/MH who experience acute difficulties are frequently shuttled between state hospitals, state supported living facilities and community placements with little or no continuity of care.

In order to fill existing gaps in services for this special population, Project Janus, Inc. proposes the establishment of an array of integrated services to cover the full continuum of need. This continuum should include a) prevention/early intervention services, b) treatment for specific psychiatric and behavioral disorders, and c) crisis intervention services. The current absence of such an integrated array of services has resulted in ineffective treatment and support for this population. Consequently, many individuals with ID/MH experience a revolving door of hospitalizations and failed community placements. Some also experience incarceration or homelessness. In addition to the negative impacts experienced by individuals with a dual diagnosis, these revolving doors also negatively impact their family members and service providers, and prove costly to state and local governmental bodies.

Project Janus, Inc. seeks to support and coordinate an effective, integrated and seamless continuum of services that will allow individuals with ID/MH to end this revolving door experience and instead have local access to the level and type of services they require. This, in turn, will insure that each person has the opportunity to continue living in, or quickly return to, the least restrictive environment.

Project Janus, Inc. also believes that the focus of the comprehensive treatment model should be based on a systematic and integrated approach to assessment and therapy, combined with a collaboration of psychiatric and psychological services provided by professionals with advanced training in the specialty of treating individuals with a dual diagnosis of ID/MH. The service model should include at a minimum 1) caregiver/provider training and education, 2) behavioral day treatment, 3) specialized behavioral health clinic services, 4) short-term acute residential treatment services and 5) long term residential services.

At the present time, Project Janus, Inc. provides caregiver/provider training and education in a classroom setting and hope to expand this training to an on-line format. It also researches and evaluates best practices for providing services to the ID/MH population and studies existing Texas law to identify barriers to service delivery. It also works directly with the local MHMR Services Center, private service providers, local law enforcement, health care institutions, area educational entities, state hospitals and state supported living facilities to identify best practices and coordinate services.

In addition, for the past three bienniums, Project Janus, Inc. has been selected by the State of Texas to receive a grant from the Texas Legislature to develop a "best practices" pilot project model for providing services to individuals with a dual diagnosis of ID/MH. Project Janus, Inc. was also named by the 80th Session Interim House Select Committee on ICF/MR Services as a leader in promoting the integration of services for individuals with a dual diagnosis of ID/MH. To read more about the grant related work done by Project Janus, Inc. toward development of the pilot project model, click on the links below:

Report to the 80th Legislature
FY2008 Progress Report to Texas Health and Human Services Commission
White Paper submitted to Interim House Select Committee on ICF/MR Facilities