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INTEGRATED RECOVERY Lessons Learned: Implementing IDDT. Stanislaus County Elizabeth Oakes, MFT Adrian Carroll, MFT January 19, 2007. Organizational Context. Why we selected IDDT : -Committed to integrated services BHRS -Integrated system isn’t integrated treatment

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integrated recovery lessons learned implementing iddt

INTEGRATED RECOVERYLessons Learned: Implementing IDDT

Stanislaus County

Elizabeth Oakes, MFT

Adrian Carroll, MFT

January 19, 2007

organizational context
Organizational Context
  • Why we selected IDDT:

-Committed to integrated services BHRS

-Integrated system isn’t integrated treatment

-Established experience with co-occurring Tx

-Valued EBP aspect

-Interested in ‘implementation’ aspect

-Not the Money

-High mortality rate

organizational context1
Organizational Context
  • Why we selected IDDT continued:

-High co-morbidity

-High treatment failure rate

-Cost of not serving for system

-Highly underserved

-Co-occurring conditions often used as exclusion criteria, rather than inclusion criteria

organizational context2
Organizational Context
  • Goals and expectations

-Actual OP treatment track, consistent across programs, across department

-Both: broad system-wide competence;

and specialized enhanced expertise.

-ID system barriers to implementing EBPs

-Save money eventually

-Accurate identification of AOD,MH, and COD

-Develop staff training curriculum

-Increased integration

key factors
Key Factors
  • Factors that facilitated implementation :

-Staff with MH and AOD knowledge

-CIMH training

-Effective use of project planning consultant

-Inter-county collaboration

-Learning collaborative

-System-wide steering committee

-Psychiatrists early adopters

-Integrated system

-Training coordinator

key factors1
Key Factors
  • Factors that impeded implementation:

-Caseload size

-Attempting treatment before engagement

-MH downsizing and loss of funding

-Resistance from some staff

-Stigma, 2 types MH and AOD

-Lack of COD housing

-Funding categorical

team structure
Team Structure
  • Project Team - Behavioral Health Integration Oversight Committee:

-Assistant Director

-Chiefs and other key managers

-Selected site Program Coordinators

-Program Coordinators MH and AOD

-Residential AOD manager

-Training Coordinator

-Line staff

-MHSA Coordinator

team structure1
Team Structure
  • Clinical/IDDT Team

-Program Coordinator

-Psychiatrist

-Consumer

-Select MH Case managers

-Select MH Clinicians

-Select AOD counselors

benefits of integrated recovery
Benefits of Integrated Recovery
  • Saves money
  • Helps staff motivation
  • Impacts long-time ‘stuck’ clients
  • Stage-based treatment
  • Formulation helps consumers understand how 2 conditions creates a 3rd condition
  • Recovering peers from either MH or AOD can support each other
  • DRA sustained
  • Recognition with in AOD for need of specialized track
sustaining positive change
Sustaining Positive Change
  • Challenges:

-Staff changes

-Caseload size

-”Drift”

-Integration into daily practices

-Forms

-Staff passion for MH or AOD

-Separate funding

sustaining positive change1
Sustaining Positive Change
  • Successes

-Hire consumers with COD recovery

-Paperwork to forms committee

-All FSPs trained

-Written into MHSA plan

-Residential AOD with COD track

-Stages of Treatment

-MH and AOD specific stages

-MH board member trained

support wheel
SUPPORT WHEEL

Phone Numbers

Use In A Circular Manner So Not To Burn Out Any One Source

My Recovery

Be Selective In Choosing Support Phone Numbers

sustaining positive change2
Sustaining Positive Change
  • Failures

-Caseload size

-Growing own experts

-Motivational Interviewing measure

-Didn’t do own cost-benefit data

-Greater consumer/family presence on steering committee

summary of lessons learned
Summary of Lessons Learned
  • What we would do again

-We would do it again

-All of it

-Stage-based, Motivational Interviewing, AOD staff, clinical tools

summary of lessons learned1
Summary of Lessons Learned
  • What we would do differently

-Someone dedicated full time to implementation

-More MI up front

-More training for MH staff on state-of-art AOD treatment

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