Issue. Although the National Institute on Drug Abuse, Shatterproof, and other organizations have created best practice guidelines for providing treatment and services to individuals who have substance use disorders (SUD), providers who have high contact with this population aren’t always offered the training and support they need to comply. This can result in judgement and stigma, thus perpetuating problems already experienced by people who have SUD.

Description. Health district staff engaged local criminal justice, health services, and behavioral health organizations with the intention of identifying and addressing systemic and organizational barriers to improving quality of care for individuals who have SUD. Comprehensive baseline assessments were developed to understand the perspectives of clients, leaders, and staff at each organization. Clients spoke in focus groups about their experienced barriers and facilitators to care. Leaders provided information on organizational policies and procedures. Staff surveys included questions to understand their knowledge of best practices, attitudes toward clients, and organizational support.

Through dialog with leadership from each organization, the specific needs that had been identified were weighed against current capacity and feasibility, resulting in a phased work plan to address employee training needs and improve cross-sector collaboration with other organizations engaged in the project.

Lessons learned. Staff training needs varied greatly by organization and service provided. Analysis across all data sources highlighted seven areas for improvement: organizational commitment, staff training, screening/assessment/diagnosis, consultation and collaboration, care coordination, treatment, and client engagement.

Recommendations. Thorough assessment can aid in the process of identifying specific needs for an organization but must be undertaken with caution in order to avoid overburdening staff before the intervention is delivered. Engaging partners with shared clients in a collaborative process of organizational transformation allows for system-level changes beyond organizational policy and workforce development.