The Mental Health Crisis Risk Assessment (MHCR) for People for with Intellectual and Developmental Disabilities (IDD), originally developed by New Hampshire START, has been a core tool used by START programs since 2014. Informed by clinical expertise and data from the field, a second version (Caoili, Kalb, Klein, & Weigle, 2018) was implemented following a 2020 pilot study. This version enhanced the tool by incorporating measures of mental health stability, level of clinical risk, caregiver/system stress assessment, and the provider’s appraisal of needs. Subsequent feedback and analysis between 2020 and 2022 supported the development of an abbreviated version to streamline its use while preserving its clinical value.
Although the MHCR was designed within the context of START services, its utility is not limited to START programs. The assessment's structure and purpose—evaluating mental health stability, understanding support system capacity, and guiding proactive care planning—make it a valuable resource for any interdisciplinary team supporting individuals with IDD. Its strength lies in its holistic view of both the person and their system, its emphasis on service guidance rather than only crisis categorization, and its ability to track changes over time.
A recent study (Caoili, 2024) further supports the broader applicability of the MHCR by demonstrating its effectiveness across diverse care settings. This evidence reinforces its value as a structured, person-centered tool for enhancing clinical understanding and informing service provision.
The instructional manual includes a description of the MHCR, instructions for completion, and scoring guidance. The MHCR is not just a measure of crisis severity—it serves as a roadmap for providers to deliver informed, responsive, and coordinated care.
Clinical interview skills and knowledge are needed to administer the assessment. Service coordinators, clinicians, and other providers may have these skills.
If you are interested in administering the MHCR please complete the request form below.
The MHCR is also available in Spanish.
