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“You have been my friend. That in itself is a tremendous thing...By helping you, perhaps I was trying to lift up my life a trifle. Heaven knows anyone's life can stand a little of that.”            

- E. B. White from Charlotte's Web

Center for START Services

Consultation and Training in Crisis Prevention, Management, and Support for Individuals with Intellectual Disabilities and Behavioral Health Needs

The Center for START Services

START aims to enhance local capacity and provide collaborative, cost-effective support to individuals and their families through exemplary clinical services and education with close attention to service outcomes. 

START is a systems-linkage approach to supports and is an acronym for Systemic – Therapeutic-Assessment – Respite - and Treatment.  The individuals who benefit from START have intellectual disability and mental health conditions or challenging behavior that is negatively affecting their quality of life. The underlying philosophy of START is that services will be most effective when everyone involved in supports and treatment is allowed to participate actively in treatment planning and service decisions. In order for this to occur, collaboration between service providers and with service users is needed.

For more information on START, visit the Center for START Services website.


The START program model is a least restrictive model of care and support.  It offers provision of clinical assessment and support by using the following methods: training and empowerment for families and caregivers; effective positive behavior support approaches; therapeutic tools developed in collaboration with medical, allied health and mental health professionals; a residential therapeutic respite facility; and optimal utilization of existing resources through system linkages.

Information and critical elements

  • Used throughout the United States to enhance the service system though active collaboration
  • Provides professional and logistic “linkages” between service providers in multiple disciplines
  • Improves expertise across systems of care
  • Promotes the use of “generic” services whenever possible
  • “Special” services provided for those who need them
  • Sustainable blended funding
  • Services designed to fill service gaps START is an evidence based program model. 
  • START was cited as a model program at the 2002 Conference on Health Disparities and Mental Retardation.
  • The resulting report, CLOSING THE GAP: A National Blueprint to Improve the Health of Persons with Mental Retardation, is available from the Surgeon General’s office.

Research outcomes include

  • Reduction of emergency service use
  • High rates of satisfaction by families and care recipients
  • Cost-effective service delivery


UNH Institute on Disability
10 West Edge Drive
Suite 101
Durham, NH 03824
phone: 603.862.4320
relay: 711
fax: 603.862.0555
Contact the IOD