Substance abuse and mental disorders are a consistent and pervasive part of life for many people. In 2014, just shy of ten million Americans aged eighteen or older experienced a serious mental illness, over twenty million Americans twelve and older self-reported seeking treatment for alcohol or illicit drug use, and almost twelve million adults sought mental health care or counseling. By itself, substance abuse costs over $600 billion each year, and by 2020 the combined impact of mental disorders and substance abuse are projected to be the largest cause of disability across the world. But there is good news: A growing body of evidence shows that early, coordinated, community-based intervention applied when a psychosis first presents leads to improved clinical and functional results. Focused, collaborative intervention at the community level has the potential to not only save billions annually, but can result in improved lives for the millions of people who deal with these conditions or care for those who do.
One opportunity—diversion programs—offers low-level and non-violent offenders the option of enrolling in rehabilitation programs in lieu of jail time. The Seattle based-LEAD (Law Enforcement Assisted Diversion) program, has shown promise. Since 2011, over 500 people have enrolled in the program, and after six months participants were:
- 60% less likely to be arrested
- 89% more likely to have a home
- 46% more likely to have a job
The LEAD program succeeds by coordinating the efforts of several community-based groups, namely law enforcement, social workers and case managers, prosecutors, and community members. While the program is a big investment—the 2017 budget was over $2.5 million—the cost-benefits of early treatment and prevention point to clear gains in real terms, especially when considering the long-term social benefits.
Improved screening efforts by public health departments support the early identification and care for substance abusers and sufferers of mental illness. Incorporating integrated care models that include behavioral health screenings at the community level are proven methods for identifying early-intervention opportunities and providing critical, collaborative, and timely support. Methods like SBIRT (Screening, Brief Intervention, Referral to Treatment) or IMPACT (Improving Mood, Promoting Access to Collaborative Treatment) have demonstrated positive results over more traditional methods. In one study, the IMPACT model was shown to “more than double the effectiveness of depression treatment for adults in primary care settings…. These key principles of provider collaboration, joint decision-making, patient involvement, and shared accountability are hallmarks of integrated care delivery.”
Child welfare, especially in rural communities, creates unique challenges in providing early, community-based intervention. A lack of local resources, funding, and parental awareness of available resources coincide to compound an already critical issue. The link between the lack of care and the risk of future negative impacts—incarceration, poor school performance, and suicide—in youth are clear, and the wait list in some underserved environments can easily stretch to six months with only intermittent care. One solution—telemedicine—is a growing option for many communities struggling to provide adequate early support. While telemedicine allows for the higher concentration of urban-based health resources to extend their reach into the rural corners of America, such an approach begs for a stronger, more integrated platform that allows for collaborative support across a network of local and remote providers.
Providers need access to critical patient information in order to make early, timely, and informed care decisions regardless of the chosen support model, be it diversion programs, health department screenings, or even telemedicine. To learn more about how ClientTrack empowers medical, behavioral health, and social support providers to collaborate on coordinated systems of care, check out our white paper “Moving to a Comprehensive Care Plan.”
Blog Resources
https://www.samhsa.gov/prevention
https://www.samhsa.gov/prevention
https://eccoviasolutions.com/why-integrated-care-models-must-include-behavioral-health-screening/
