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Integrating Mental Health and Substance Use Services in New York State

  • By: NYSHealth
  • Date: February 2014
  • Priority Area: Integrating Mental Health and Substance Use Services
  • Type: Grant Outcome Reports
  • Category: Grant Outcome Report
  • Grantee Name: National Development and Research Institutes (NDRI)
  • Grantee Name: National Development and Research Institutes (NDRI)

Overview

Although half of the people in New York State who suffer from a mental health disorder also struggle with some form of substance use, only about 1 in 10 receive appropriate treatment for both conditions. When their conditions are not managed well, people who have both mental health and substance use disorders experience worse outcomes, including higher rates of HIV infection, drug relapse, re-hospitalizations, depression, and suicide. In 2008, NYSHealth awarded a grant to the National Development and Research Institutes, Inc., (NDRI) to establish the first statewide Center for Excellence in Integrated Care (CEIC) to assess and improve the capacity of mental health and substance use programs to provide integrated services for clients with both conditions.

Read an in depth article that summarizes the development, implementation, and outcomes of this project. 

Grantee: National Development and Research Institutes, Inc.

Dates: October 1, 2008 – November 22, 2013

Grant Amount:
      Phase 1: $3,201,644
      Phase 2: $442,570
      Phase 3: $282,290

Grantee Website: http://www.ndri.org/

Grant ID:
      2496857
      3426912
      11-02788


Grant Goals

By establishing CEIC, NDRI set out to accomplish the following goals:

  • Provide technical assistance to 600 of the approximately 1,000 licensed outpatient mental health and certified substance use programs in New York State to increase their capacity to deliver integrated mental health and substance use treatment services; and
  • Hold various meetings to engage stakeholders, including a policy meeting with federal and State policymakers; a technical meeting with health plans and State personnel; and individual meetings with nine health insurance companies to discuss their preferences, feedback, and recommendations.

Grant Outcomes

NDRI achieved the following outcomes:

  • Hosted 13 leadership forums designed to introduce CEIC services to region and county leaders working throughout New York State;
  • Exceeded their original goal by providing individual technical assistance to 603 licensed mental health and substance use clinics through on-site assessments of a program’s existing level of capability to serve patients with co-occurring mental health and substance use conditions;
  • Used the Dual Diagnosis Capability in Addiction and Mental Health Treatment indices—an established assessment tool—to conduct a comprehensive review of capability;
  • Wrote a summary report to participating sites that included recommendations and guidance for improvements, and then provided sites with additional implementation support to assist with these recommendations;
  • Conducted follow-up visits to 150 sites to assess whether programs were improving their ability to provide integrated services to patients with co-occurring mental health and substance use disorders;
  • Held 24 forums on building capability to share collective observations from site visits, explore consistent themes that emerged, and discuss strategies for advancing capability;
  • Offered a 15 sessions of the supplemental workshop, “Building Integrated, Recovery Oriented Outpatient Services,” which was designed to assist outpatient service providers with integrating peer supports into their programs; and
  • Developed and managed a website to catalogue activities, connect interested programs to services, and offer participants a library of resources. Key resources are available here

At the start of the initiative, only 22% of New York State’s licensed mental health and substance use programs were rated as being capable of offering integrated care to clients. In follow-up assessments—an average of two years later and after having received technical assistance—the percentage of programs rated as capable had more than doubled to 52%. Based on the percentage of clients in treatment who have a co-occurring disorder in New York State, it is estimated that roughly 234,000 clients were served by clinics that participated in the initiative, and thus have benefitted from CEIC’s technical assistance to improve integrated care

Additional analyses suggest a systemwide improvement among licensed substance use clinics. These analyses showed that programs that received CEIC services were significantly more likely to implement service integration—delivering treatment for both conditions through coordination, collaboration, and specialized training. In addition, clients who received treatment from clinics that became more capable at delivering integrated care stayed in treatment longer, which is a an important predictor of positive patient outcomes.

 


New Yorkers Coping with Mental Health and Substance Use Conditions Find Hope Through Improved Care
Cheryl, 60-year-old grandmother, led a double life for years—as a respected secretary in the Office of the Mayor, and as a severe alcoholic whose addiction was fueled by undiagnosed mental illness. Cheryl eventually hit rock bottom—losing her job and her family, and ending up homeless and living on the streets. Cheryl went on to rebuild her life and reclaim her dignity after finally getting treatment for both her substance use and mental health issues at a clinic that had improved its delivery of care for clients struggling with both conditions. Learn more.