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Mental Health, Addictions Counseling and Medical Services Linkages

Mental Health, Addictions Counseling and Medical Services Linkages. May 29, 2013. For Audio: Dial-in#: 866.394.2346 Participant Code: 397 154 6368#. Welcome & Overview, 5 mins Integrating Mental Health, Substance Use and Medical Programs 30 mins

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Mental Health, Addictions Counseling and Medical Services Linkages

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  1. Mental Health, Addictions Counseling and Medical Services Linkages May 29, 2013 For Audio: Dial-in#: 866.394.2346 Participant Code: 397 154 6368#

  2. Welcome & Overview, 5 mins Integrating Mental Health, Substance Use and Medical Programs 30mins Panel Discussion on Behavioral Health and Medical Service Integration, 20 mins Wrap-up & Evaluation, 5 mins Agenda Michael Hager in+care Campaign Manager National Quality Center New York, NY michael@nationalqualitycenter.org Conversation opportunities throughout webinar

  3. Welcome & Overview • This Partners in+care webinar is offered as part of the in+care Campaign. • The in+care Campaign is a national effort to improve retention in HIV care. • Webinars are one of many Partners in+care activities designed to engage people living with HIV/AIDS and their allies in the in+care Campaign. For more information: www.incarecampaign.org

  4. This is a “public event.” If you have confidentiality concerns: Your names appear on-line in the list of webinar registrants -consider just listening to the audio or to viewing the webinar at a later time, after it is posted at www.incarecampaign.org All webinars are recorded - do not use identifying information when asking questions Participation Guidelines For Audio: Dial-in#: 866.394.2346 Participant Code: 397 154 6368#

  5. Actively participate and write your questions into the chat area during the presentation; we will also have a “pop up” question exercise, and will pause for conversation during the webinar Do not put us on hold Mute your line if you are not speaking (press *6, to unmute your line press #6) The slides and recording of this and other Partners in+care webinars are available for playback and group presentations at www.incarecampaign.org – “Resources” tab Participation Guidelines For Audio: Dial-in#: 866.394.2346 Participant Code: 397 154 6368#

  6. Service Integration and Linkages Pop-up Question Does your organization offer its patients access to behavioral health or medical services? Yes, we are a one-stop shop. Everything onsite! Yes, we have a formal linkage arrangement with outside providers that is not grant supported Yes, we have a formal linkage arrangement with outside providers that is grant supported I have no idea… I do not work for an HIV service organization Adam Thompson Peer Consultant National Quality Center Fredricksburg, VA adamtthompson@gmail.com Visit www.incarecampaign.org

  7. The Substance Abuse and Mental Health Services Administration (SAMHSA) is the agency within the U.S. Department of Health and Human Services that leads public health efforts to advance the behavioral health of the nation. SAMHSA's mission is to reduce the impact of substance abuse and mental illness on America's communities. WWW.SAMHSA.GOV Humberto M. Carvalho, MPH Project Officer Health Systems Branch/Division of Services Improvement Center for Substance Abuse Treatment E-mail: humberto.carvalho@samhsa.hhs.gov David C. ThompsonTeam Leader-HIV/AIDS ProgramsHealth Systems Branch/Division of Services ImprovementCenter for Substance Abuse TreatmentE-mail: david.thompson@samhsa.hhs.gov

  8. Integrating substance abuse, mental health and HIV services • Currently funding grants to support substance abuse and mental health services integrated with HIV prevention and treatment services • Targeted Capacity Expansion Program: Substance Abuse Treatment for Racial/Ethnic Minority Populations at High-Risk for HIV/AIDS – 2012 grant -52 grantees awarded • Targeted Capacity Expansion: Substance Abuse Treatment for Racial/Ethnic Minority Women at High Risk for HIV/AIDS - 2013 grant

  9. New Orleans AIDS Task Force Juliet Catrett, LCSW-BACS Behavioral Health Supervisor Email: julietc@noaidstf.org Lisa Breland Director of Client Services Email: lisab@noaidstf.org

  10. Recovery Works Program NO/AIDS TASK FORCE

  11. Client Demographics: Gender: Male: 75.5% Female: 20.2% Transgender: 3.8% Race: Most clients identify as Black/African American (52.4%) or White (33.2%) Hispanic/Latino: 5.8% • Mean age was 41.2 years of age with most clients having a high school/GED or lower (62.5%) education level

  12. Clients’ Housing and Income • Mean monthly income: $657.24 • Most clients are unemployed (38%) or disabled or retired (36.5%) • Most clients live in own apartment (54.8%) or someone else’s apartment/house (23.1%)

  13. Significant Changesfrom Intake to 6 Month Follow Up • ASI Composite Drug Use Score • ASI Composite Alcohol Use Score • Days of illegal drug use • Days of illegal drug use index • Days of drug use, substance of choice • Days of alcohol use to intoxication • Days experiencing alcohol problems • Amount of money spent on alcohol • Drug severity Index Rating (from the SIR) • Alcohol Severity Index Rating (from the SIR) • Males’ mean number of male partners • Percentage of clients using drugs or alcohol before or during sex

  14. Substance Use: Intake to Six Month Follow Up

  15. High Risk Sexual Behaviors: Intake to 6 Month Follow Up, Males

  16. Outreach • Our Outreach team is responsible for distributing program pamphlets to other ASOs and residential programs, recruiting clients, and completing follow up GPRAS. Our completion rate for follow up GPRAS was 89.2%

  17. Agencies Contacted through Outreach Program

  18. Informational Materials Distributed to Agencies

  19. Number of Potential Clients Referred to Program

  20. Clients Enrolled in Recovery Works

  21. AIDS ALABAMA Dr. Joseph E. Schumacher Evaluator for the AIDS Alabama LIBCAP Program.  Professor of Medicine, Clinical Psychologist, and Behavioral Scientist in the Division of Preventive Medicine at The University of Alabama at Birmingham. Email: jschumacher@uabmc.edu Mitchell Traver Living In Balance Chemical Addiction Program Coordinator AIDS Alabama Email: mitchell.tarver@aidsalabama.org

  22. LIBCAPLiving in Balance Chemical Addiction Program Elaine Cottle Mitchell Tarver Dr. Joseph E. Schumacher The LIBCAP Team from AIDS Alabama This project was sponsored by a grant to ADIS Alabama from the Substance Abuse and Mental Health Services Administration (SAMHSA) of the Department of Health and Human Services (DHHS).

  23. AIDS Alabama • Incorporated as a nonprofit in 1986 with the mission of serving persons with HIV. • AIDS Alabama is the largest HIV/AIDS service provider in the state • HIV testing, prevention, and housing (170,000 nights of housing to 750 HIV-positive individuals and their families) • Only agency in the state with substance abuse and mental health programs for PLWHA.

  24. LIBCAP: The Story • Elaine and Dr. Schumacher meet • Evidence-based treatment • Needs assessment and training plan • SAMHSA HIV capacity expansion grant in 2009 • Last year of LIBCAP grant • Sustainability

  25. LIBCAP • Substance abuse treatment, housing, vocational development, case management, and aftercare program. • Problems related to drug and alcohol addiction and homelessness among persons living with HIV and AIDS. • Four housing-based treatment phases: The Rectory, Next Step, and Re-Entry. • Living in Balance: Moving from a Life of Addiction to a Life of Recovery(Hoffman, Landry, and Caudill, 2003)

  26. Living in Balance • Listed in NREPP and published by the HazeldenFoundation • 33 scripted sessions of didactic, experiential, and psycho-education strategies focusing on drug education, relapse prevention, and HIV/STD prevention • Each session contains similar elements including visualization/relaxation exercises, group exercises, written/oral exercises, role-play activities, and homework assignments.

  27. Program Evaluation • Intake rate: 307/405 = 75.8% • Follow-up rate: 219/274 = 79.9% • GPRA outcomes • Site specific assessments • DSM IV SUD Checklist • Patient Health Questionnaire (PHQ) • Treatment Readiness Ruler (TRR) • HIV Risk Assessment for Positives (HRAP) • Tobacco Use Questionnaire (TUQ)

  28. GPRA Outcomes

  29. Table 1. Demographic characteristics by treatment completion status

  30. Table 2. Substance use disorders by treatment completion status

  31. Table 3. Psychosocial characteristics by treatment completion status

  32. Lessons Learned • HIV Specific Treatment: Blessing and a Curse • Men + Women +LBGT = Drama • Vocational goals were difficult to meet • Retention and Completion Challenge • Good chances of sustainability

  33. Panel Discussion

  34. Integrating Behavioral Health and Medical Services Panel Discussion David Thompson SAMHSA david.thompson@samhsa.hhs.gov Adam Thompson NQC adamtthompson@gmail.com Joseph Schumaker, MD AIDS Alabama jschumacher@uabmc.edu Juliet Catrett, LCSW-BACS NO AIDS Task Force julietc@noaidstf.org Lisa Breland NO AIDS Task Force lisab@noaidstf.org

  35. Partners in+care Resources Visit Web / Open the Toolkit www.incarecampaign.org - “Partners” tab Sign up for Partners in+care Networkwww.incarecampaign.org – “Partners” tab Join Facebook Send email to incare@NationalQualityCenter.org – “Facebook” in subject line Campaign Headquarters:National Quality Center (NQC)90 Church Street, 13th floor New York, NY 10007Phone 212-417-4730

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