Imagine someone with an intellectual or developmental disability (I/DD) experiencing severe anxiety. First, they or a family member must find a healthcare professional. That provider must recognize how anxiety might present differently in a patient with communication differences, where a patient may be expressing themselves through challenging behaviors.
Then, the provider must be able to communicate effectively with their patient, identify potential “diagnostic overshadowing” —such as mental health symptoms being misattributed to a patient’s preexisting disability—and determine appropriate treatment adapted to the patient’s needs and abilities.
In communities with limited healthcare resources, especially rural areas, finding a provider with specialized I/DD training can be harder still.
Where Mental Health and Disability Expertise Meet
From 2019–2026, the University of Alaska Anchorage Center for Human Development implemented the Mental Health and Developmental Disabilities (MHDD) ECHO Program. Using the evidence-based ECHO Model, the program brought together a multidisciplinary group of mental health, primary care, disability, and other support professionals to share knowledge, learn to work as an effective team, and improve care for people with I/DD.
“The goal was to break down barriers through training and education for multiple provider types,” says Jessica Harvill, MPH, director, Project ECHO at the University of Alaska Anchorage. They reached a national audience of behavioral health providers, disability service professionals, educators, social workers and students, averaging 276 participants.
Post-session evaluations offered a glimpse of how participants intended to apply what they learned. One participant planned to write more descriptive notes, recognizing that documentation affects how other professionals work with the people they serve. Another reflected on how documentation could affect access to services:
“The right documentation gets services; damning documentation can help get services—but also can prevent someone from getting a fair shake.”
Three Lessons for Other ECHO Partners
Over time, the ECHO Program adapted to Hub team changes, participant feedback, emerging priorities and available resources. These experiences generated three key lessons that may inform the development and long-term sustainability of other ECHO Programs.
1) Keep the program fresh
Periodically rotating subject matter experts strengthens a mature ECHO Program by reducing facilitator fatigue; new perspectives are introduced, and professional networks expand.
2) Include team members with lived experience
When it comes to Hub planning, people with lived experience bring perspectives that help identify emerging practice needs and shape relevant educational content. They are contracted and paid, like all Hub team members, for their experience and expertise.
“It was a real value of ours to ensure that people with lived experience were members of the Hub team, not just guest speakers. Their thoughts, feedback and guidance helped shape the curriculum and determine what was important to share,” says Katie Spears, ECHO coordinator.
That sentiment was amplified by ECHO participants. In a post-session evaluation one participant shared about a Hub Team member “[I] loved that such a knowledgeable self-advocate presented. He proved the important of nothing about us without us.”
3) Let the curriculum evolve
When the MHDD ECHO began, needs assessments showed a fundamental gap: providers often had expertise in either mental health or I/DD, but not both. That made foundational training important early on. Over time, participants gained knowledge and confidence, allowing the curriculum to move beyond foundational concepts to more complex clinical topics encountered in practice. The evolution also created more opportunities for participants to learn from one another.
Looking Ahead
The MHDD ECHO Program’s current funding has ended, but the need remains. The team hopes other ECHO Hubs will build on its work and is pursuing future funding and training opportunities.
The team also plans to reconnect with former participants to learn whether—and how—they applied their learning in practice. Those answers could provide a clearer picture of the program’s long-term impact.
“The funding may have ended, but the project hasn’t ended, because the needs haven’t gone away,” Harvill says. “As long as the needs are there, then we need to find a way to continue addressing them.”
Stay in Touch
- Learn more about the MHDD ECHO Program on their iECHO page.
- Subscribe to the mailing list to stay up to date on series announcements.
- Note: The ECHO Program is on hiatus while they seek funding to support future programs.
Featured Image Credit: Adobe Stock, licensed October 2026.
