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APHA Scientific Session and Event Listing

Andrew L. Homer, PhD¹, Heather Gotham, PhD², Ron Claus, PhD², Patricia Stilen, MSW³, and Sally Baehni, MDiv³. (1) University of Missouri - Columbia, Missouri Institute of Mental Health, P.O. Box 687, Jefferson City, MO 65101, (573) 751-8055, andrew.homer@dmh.mo.gov, (2) University of Missouri-Columbia, Missouri Institute of Mental Health, 5400 Arsenal Street, St. Louis, MO 63139, (3) University of Missouri-Kansas City, Mid-America Addiction Technology Transfer Center, 5011 Rockhill Road, Kansas City, MO 64110

[Part of session: “Co-occurring substance use and mental disorders: Epidemiology, policy, practice, and costs.” Charlene Le Fauve, organizer, charlene.lefauve@samhsa.hhs.gov, session abstract # 139244.]

SAMHSA's Co-occurring State Incentive Grant (COSIG) program enables states to improve services for persons with co-occurring substance use and mental disorders. In Phase 1 of its COSIG project Missouri used a 2 (rural vs. urban) by 2 (joint vs separate alcohol and drug or mental health agency) design to study services implementation for this population. Service models included the consensus and evidence-based practices described in Center for Substance Abuse Treatment's TIP 42 and in Center for Mental Health Services' Integrated Dual Diagnosis Treatment Resource Kit. Training ranged from global training on attitudes and values surrounding alcohol, drug abuse and mental health, general knowledge of the areas, to specific skills such as motivational interviewing, and screening and assessment instruments. Impact on agency practices was assessed using an adaptation of the Dual Diagnosis Capability in Addiction Treatment fidelity assessment instrument at the project onset and 24 months later. Changes in practice will be described. In Phase 2, Missouri developed a logic model to guide expansion beyond the pilot sites. The model calls for systemic changes including the development of contracts, rules and regulations to guide practice implementation, and the development of improved billing and tracking systems. The model also calls for additional training and skill development and issuing an RFA to solicit agencies that want to implement evidence-based practices.

Learning Objectives: At the conclusion of the presentation, participants will be able to

• Apply lessons learned from Missouri's experience with changing the service system for persons with co-occurring disorders.
• Describe how evidence-based and consensus practices were employed to improve services.
• Describe findings from the state's evaluation of the process.

Keywords: Substance Abuse Treatment, Mental Health Services

Presenting author's disclosure statement:

Any relevant financial relationships? No