Transcript DDRAC_MHSADivisionOverview_121907

Mental Health and
Substance Abuse Services
Joe Vesowate
Assistant Commissioner
Organizational Structure
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Division Summary
• Substance Abuse Prevention, Intervention, and Treatment
Services
• Inpatient Psychiatric Services
• Community-Based Mental Health Services
• Projects for Assistance in Transition from Homelessness
(PATH)
• NorthSTAR – Community-Based Mental Health, Substance
Abuse and Co-Occurring Services
• South Texas Health Care System
• Texas Center for Infectious Disease (TCID)
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Substance Abuse Prevention and
Early Intervention Services
• Primary Prevention
• HIV Early Intervention and Outreach
• Outreach, Screening, Assessment and Referral Services
(OSAR)
• Tobacco Prevention and Control
• Pregnant and Post-partum Intervention for Women (PPI)
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PREVENTION OUTCOMES
Outcomes Positive among Youth in DSHS-Funded
Substance Abuse Prevention Over Time
Percent of Youth Completing SA Prevention
100%
85%
88%
Number of Schools Participating in SA Prevention
88%
2,500
2,087
75%
2,000
1,875
1,699
1,500
50%
1,000
25%
500
0%
FY2005
FY2006
0
FY2007
FY2005
Source: DSHS Behavioral Health Integrated Provider System (BHIPS).
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FY2006
FY2007
PREVENTION OUTCOMES
Percentage of Texas Youth Who Used Substances
in the Past Month Decreasing Over Time
50%
2002
Percentage
40%
2004
2006
35%
33%32%
30%
18%17%
15%
20%
16%
14%13%
14%13%
11%
7% 7% 6%
10%
0%
Alcohol
Tobacco
Any Illicit
Drug
Marijuana
Source: Texas School Survey of Substance Use, DSHS.
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Inhalants
Substance Abuse
Treatment Services
• Detoxification
• Intensive and Supportive Residential (adult and youth)
• Outpatient (adult and youth)
• Opioid Replacement Therapy
• Co-Occurring Psychiatric and Substance Abuse
Disorders (COPSD) Services
• Specialized Female Services
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TREAMTMENT OUTCOMES
Clinical Outcomes Positive among Adults
Completing DSHS-Funded Substance Abuse
Treatment Over Time
FY2005
0%
25%
FY2006
FY2007
50%
75%
100%
66%
62%
63%
Percentage Completing
Treatment
83%
85%
87%
Percentage Reporting
Abstinence at Follow-Up
61%
60%
63%
Percentage Gaining
Employment at Follow-Up
98%
98%
98%
Percentage Not ReArrested at Follow-Up
Source: DSHS Behavioral Health Integrated Provider System (BHIPS).
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TREATMENT OUTCOMES
Clinical Outcomes Positive among Youth
Completing DSHS-Funded Substance Abuse
Treatment Over Time
FY2005
0%
25%
FY2006
FY2007
50%
75%
100%
60%
57%
59%
Percentage Completing
Treatment
84%
84%
88%
Percentage Reporting
Abstinence at Follow-Up
94%
94%
95%
Percentage with Positive
School Status at Follow-Up
97%
97%
96%
Percentage Not ReArrested at Follow-Up
Source: DSHS Behavioral Health Integrated Provider System (BHIPS).
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Current and Emerging
Challenges
• Increase in methamphetamine use
• Emergence of “Cheese” Heroin usage by youth
• Changing trends in use patterns
• Cost pressures on treatment providers
• Workforce development
• Availability of specialized services
• Ensuring a continuum of care and appropriate use of
clinical information
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DRUG USE TRENDS
Cocaine and Alcohol Decreasing, while Marijuana,
Methamphetamines, and Opioids Increasing as
Primary Substances for Which Adults Seek
DSHS-Funded Substance Abuse Treatment
Alcohol
Cocaine
Methamphetamine
Marijuana
Opioid
Other
100%
Percentage
75%
50%
15%
15%
15%
15%
16%
16%
17%
18%
18%
17%
18%
4%
7%
5%
9%
4%
9%
5%
10%
6%
7%
8%
10%
10%
10%
13%
15%
13%
9%
10%
11%
12%
13%
29%
28%
27%
34%
34%
35%
33%
29%
28%
29%
29%
25%
37%
36%
36%
36%
36%
1999
2000
2001
36%
33%
31%
27%
26%
26%
2003
2004
2005
2006
2007
0%
1997
1998
2002
Fiscal Year
Source: DSHS Behavioral Health Integrated Provider System (BHIPS).
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DRUG USE TRENDS
Alcohol Decreasing while Marijuana Increasing as
Primary Substances for Which Youth Seek
DSHS-Funded Substance Abuse Treatment
Alcohol
Cocaine
Methamphetamine
Marijuana
Opioid
Other
100%
Percentage
75%
50%
68%
71%
73%
74%
75%
75%
74%
76%
75%
75%
75%
12%
12%
10%
9%
8%
8%
9%
8%
8%
7%
7%
1997
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
25%
0%
Fiscal Year
Source: DSHS Behavioral Health Integrated Provider System (BHIPS).
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Partnerships and
Stakeholder Engagement
• Texas Education Agency (TEA)
• Education Service Centers (ESC) - expanding role
of School Health Specialist to include MH promotion
and substance abuse prevention efforts
• Legislative direction to implement tobacco education
program in schools
• Drug Demand Reduction Advisory Committee
(DDRAC)
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Partnerships and Stakeholder
Engagement (cont’d.)
• Rural Border Initiative (RBI)
• Provides substance abuse services in Health & Human Service Regions
8, 10, and 11, covering 15 counties (including Colonias)
• Creates and expands service linkages along a continuum of substance
abuse prevention, intervention, and treatment, while at the same time
strengthening individuals, families and communities through
mobilization and empowerment.
• Utilizes trained community members as volunteers and mentors, and
have significantly increased the use of Community Health Workers
(Promotores), trained outreach workers from the target population.
• Created alliances with HHSC’s Colonias Initiative, DSHS’ Office of
Border Health, and Texas A&MPage
University
(TAMU) Colonias Projects
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(CHUDs).
System Improvement
• Clinical Management Behavioral Health System (CMBHS)
• Access to Recovery (ATR)
• Screening, Brief Intervention, Referral, and Treatment (SBIRT)
• Crisis Counseling Program Initiatives
• Substance Abuse Services Performance Improvement
• Actively seeking new funding opportunities
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Clinical Management Behavioral
Health System (CMBHS)
• Integrated clinical management tool for Substance
Abuse and Mental Health service providers
• Capture demographic, service and clinical data for
Substance Abuse and Mental Health clients
• Track service utilization and client progress
• Facilitate State and Federal reporting
requirements
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Access to Recovery
(ATR)
• Federal SAMHSA Grant awarded 2004
•
•
•
•
$22.8 million for three years
Federal target 8,928 clients; served 15,000
Voucher issued to client rather than contract with provider
30 participating drug courts in 13 counties
• Second ATR Meth Grant awarded 2007
• $13.5 million for three years
• Federal target 6,038 clients
• Focus on methamphetamine use
• Partnership with Governor’s Office/Criminal Justice
Division
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Screening, Brief Intervention
and Treatment (SBIRT)
• Federal initiative designed to integrate
screening, brief intervention, and referral
treatment services for substance abuse
problems into routine delivery of medical care
• Creates bridge between general medical
system and the substance use disorders
delivery system
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Crisis Counseling
Program Initiatives
• Ensuring comprehensive disaster response and
recovery plan by integrating substance abuse into
State’s Disaster Behavioral Health Plan
• Collaborating with substance abuse OSAR centers to
ensure that substance abuse services remain consistent
during and after a disaster
• Providing easier access to community resources that
will significantly enhance delivery of crisis counseling
services following disasters
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Substance Abuse Services
Performance Improvement
• The Texas Recovery Initiative (TRI)
• Partnership between DSHS and the substance abuse
treatment and recovery communities
• Identify opportunities and methods for improving the quality
and effectiveness of services provided to adult population
• Process will consist of a series of community meetings,
creation of a task force and the presentation of a set of
summary findings for service improvement and
recommendations
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