Oklahoma’s Integrated Services Initiative

1. Oklahoma’s Integrated Services Initiative For Treatment of Persons With Co-Occurring Substance Use and Mental Health Disorders

2. What is it? • A consensus plan of action that is consumer-driven and recovery-focused, supported by key advocacy and service organizations, for the development of a system of care that has the capacity to provide integrated services to Oklahomans with mental health and substance use and other addictive disorders in a trauma-informed manner.

3. How It Happened • ODMHSAS applied for Co-Occurring State Incentive Grant • Notification SAMHSA awarded state $3.3 million over five years to improve infrastructure • Shortly after, Oklahoma was invited to 2nd National Policy Academy on Co-Occurring Disorders • Decision made to roll CO-SIG into larger initiative

4. Why It’s NeededWe were not treating the people who show up at the front door • PARALELL SERVICE DELIVERY SYSTEM • LIMITED COLLABORATION AND ALMOST NO INTEGRATION • CARE DELIVERED IN A PARALELL OR SEQUENTIAL FASHION (REVOLVING DOOR) • MOST SEVERE CASES ARE ENDING UP IN PRISONS OR JAILS

5. NATIONAL PREVELANCE • SAMHSA REPORTS ABOUT ONE HALF OF PERSONS IN TREATMENT PROGRAMS FOR MENTAL HEALTH OR SUBSTANCE ABUSE ISSUES HAVE CO-OCCURRING DISORDERS. • 4.2 MILLION ADULTS AGES 18 MET THE MEDICAL CRITERIA FOR SUBSTANCE ABUSE AND MENTAL ILLNESS (SAMHSA NEWS RELEASE JANUARY 31, 2005)

6. OKLAHOMA PREVELANCE • DATA FROM THE NATIONAL HOUSEHOLD SURVEY IN 2001 EXTRAPOLATED FOR OKLAHOMA SUGGESTS THAT BETWEEN 42,570 AND 54,011 OKLAHOMANS MEET THE DIAGNOSTIC CRITERIA FOR CO-OCCURRING DISORDERS • FY 03’ ICIS DATA SHOWS THAT ABOUT 4,300 PERSONS WERE IDENTIFIED WITH CO-OCCURRING DISORDERS. MOST OF THOSE WERE IDENTIFIED THROUGH THE MENTAL HEALTH SYSTEM.

7. Oklahoma Integrated Services Initiative Domestic Violence – Sexual Assault – Physical Abuse – Violent Perpetrators – Witnesses to Violent Acts – Emotional Abuse Trauma Informed Fully Integrated Basic Mental Health Programs Basic Addiction Programs Intermediate COD Programs Advanced COD Programs Advanced COD Programs Intermediate COD Programs Fully Integrated Substance Abuse System Mental Health System

8. Levels of Program Capability for Co-Occurring Disorders • Basic Addiction – Programs which by choice or lack of resources are capable of treating substance use disorders only. These programs have the ability to screen for mental health disorders and symptoms of or situations related to trauma and refer to co-occurring intermediate, advanced or trauma specific programs as needed. • Basic Mental Health – Programs which by choice or lack of resources are capable of treating mental health disorders only. These programs have the ability to screen for substance use disorders and symptoms of or situations related to trauma and refer to co-occurring intermediate, advanced or trauma specific programs as needed. • Intermediate Substance Abuse-Co-Occurring Disorder Programs (ASAM Dually Diagnosed Capable) – The primary focus of these programs is on the treatment of substance-related disorders but they are capable of treating persons who have relatively stable diagnostic or subdiagnostic co-occurring mental health problems related to an emotional, behavioral or cognitive disorder. They also have the ability to screen, assess and treat persons who have experienced trauma and to refer to trauma specific programs as needed. • Intermediate Mental Health-Co-Occurring Disorder Programs(ASAM Dually Diagnosed Capable)– The primary focus of these programs is on the treatment of mental health disorders but they are capable of providing treatment for primary substance use disorders. They also have the ability to screen assess and treat persons who have experienced trauma and to refer to trauma specific programs as needed. • Advanced Programs(ASAM Dually Diagnosed Enhanced) – are capable of treating individuals with unstable or disabling co-occurring mental disorders in addition to the person’s substance-related disorders and persons who have experienced trauma. They also have the ability to screen assess and treat persons who have experienced trauma and to refer to trauma specific programs as needed.

9. ODMHSAS Leadership Integrated Services Initiative Leadership Integrated Services Initiative Advisory Group Screening Assessment Outcomes/ Evaluations Training Finance Workforce Development Systems Integration Regional Change Agent Planning Groups Tulsa Oklahoma City Lawton McAlester Woodward Tahlequah Model Program Sites Norman/ Oklahoma City Tulsa Vinita/ Tahlequah

10. HELP ON THE HORIZON • SAMHSA FUNDED INFRASTRUCTURE GRANT (COSIG) $3.3 MILLIOIN OVER 5 YEARS TO HELP WITH SYSTEM AND SERVICE INTEGRATION • SAMHSA FUNDED CO-OCCURRING POLICY ACADEMY • SAMHSA FUNDED COCE • CSAT TIP 42 FOR COD • SAMHSA FUNDED IDDT TOOLKIT FOR COD

11. ODMHSAS INITIATIVES • COSIG GRANT • COD POLICY ACADEMY • RECOVERY COLLABORATIVE • CHILDREN’S BEHAVIORAL HEALTH INITIATIVE • NINE EXISITING PROGRAMS WHICH OFFER CO-OCCURRING SERVICES • MENTAL HEALTH COURT • PACT • INTEGRATED CASE MANAGEMENT • DOUBLE TROUBLE IN RECOVERY PROJECT • RWJ PATHWAYS TO RECOVERY GRANT

12. CONTACT • L. D. BARNEY, ICAADC • ODMHSAS CO-OCCURRING PROGRAM SPECIALIST • COSIG PROJECT COORDINATOR • PARTICIPANT COD POLICY ACADEMY • ldbarney@odmhsas.org • (405) 522-4939