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The Oklahoma  Integrated Services Initiative (OISI) . and the SAMSA, COSIG Project

The Oklahoma  Integrated Services Initiative (OISI) . and the SAMSA, COSIG Project. Andrew Cherry Endowed Professor of Mental Health Project Evaluator OU-Tulsa, School of Social Work 3-23-2005. COSIG SYNOPSIS.

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The Oklahoma  Integrated Services Initiative (OISI) . and the SAMSA, COSIG Project

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  1. The Oklahoma  Integrated Services Initiative (OISI).and theSAMSA, COSIG Project Andrew Cherry Endowed Professor of Mental Health Project Evaluator OU-Tulsa, School of Social Work 3-23-2005

  2. COSIG SYNOPSIS • On October 5, 2004, The Oklahoma Department of Mental Health and Substance Abuse Services (ODMHSAS) was one of four states to receive a five year Co-Occurring State Incentive Grants (COSIG) from the Substance Abuse and Mental Health Services Administration (SAMHSA). There are 11 COSIG states participating in this incentive. COSIG Overview 3-23-5

  3. The Oklahoma COSIG Project • The Oklahoma COSIG project will seek to develop an integrated system of care for persons with co-occurring disorders in State funded mental health and substance abuse treatment facilities that is accessible to consumers and their families, culturally competent, and grounded in evidence-based practices. COSIG Overview 3-23-5

  4. Two goals are proposed to guide this project • Goal 1. Develop, implement and evaluate a standard protocol for the screening and assessment of mental health and substance abuse treatment service recipients in all State funded programs. • Goal 2. Develop, implement and evaluate an integrated treatment model for persons with co-occurring disorders that is accessible, culturally competent, and grounded in evidence-based (i.e., empirical-based and consensus-based) practices. COSIG Overview 3-23-5

  5. COSIG States: Transforming the Way Our Nation Addresses Co-occurring Disorders COSIG Overview 3-23-5

  6. The Public Health Model A community approach to preventing and treating illnesses. Its premise is that caring for the health of an individual protects the community, while—in turn—caring for the health of a community protects the individual—with society at large reaping the overall rewards. COSIG Overview 3-23-5

  7. Estimated Prevalence of Co-occurring Disorders • 50% of homeless adults with serious mental illnesses have a co-occurring substance abuse disorder • 16% of incarcerated individuals have severe mental and substance abuse disorders • Among detainees with mental disorders, 72% also have a co-occurring substance abuse disorder COSIG Overview 3-23-5

  8. Mental Illnesses and Substance Use Disorders Percent of persons with mental illnesses who also will develop a substance use disorder Persons with mental illnesses Co-occurring disorder Up to 50% COSIG Overview 3-23-5

  9. Substance Use Disorders and Mental Illnesses Adults with mental illnesses Adults with mental illnesses 20.4% 7% All persons Persons with a substance use disorder Source: Serious Mental Illness and Its Co-Occurrence With Substance Use Disorders, Substance Abuse and Mental Health Services Administration(2004). COSIG Overview 3-23-5

  10. Substance Use among Adults Aged 18 or Older, by SMI: 2003 Percent Using COSIG Overview 3-23-5

  11. Substance Dependence or Abuse among Adults Aged 18 or Older, by SMI: 2003 Percent Dependent or Abusing in Past Year COSIG Overview 3-23-5

  12. 15.2 Million 15.4 Million 4.2 Million Substance Use Disorder Only SMI Only Co-Occurring Disorders Co-Occurrence of SMI and Substance Use Disorders among Adults Aged 18 or Older: 20034.2 million = 12% COSIG Overview 3-23-5

  13. Past Year Treatment among Adults Aged 18 or Older with Co-Occurring SMI and a Substance Use Disorder: 2003 Treatment Only for Mental Health Problems Treatment for Both Mental Health and Substance Use Problems 39.8% 7.5% 3.7% Substance Use Treatment Only No Treatment 49.0% 4.2 Million Adults with Co-Occurring SMI and Substance Use Disorder COSIG Overview 3-23-5

  14. People in Oklahoma with a Co-occurring Disorder • If we estimate the number of people in Oklahoma with co-occurring disorders, based on national norms, the number could be as high as 54,000 persons. ODMHSAS data from the Integrated Client Information System (ICIS) collected in 2003, found only 4,000 persons identified as having a co-occurring disorder. • This suggests a significant undercount caused by a lack of recognition and diagnostic skills among current professional staff. COSIG Overview 3-23-5

  15. Treatment and Servicesin Oklahoma • While the number of people in Oklahoma with a co-occurring disorder is still only an estimate, • The people with co-occurring disorders who are not receiving the most effective treatment are experiencing high recidivism rates and numerous treatment episodes. • COSIG is designed to address this lack of appropriate treatment and services. COSIG Overview 3-23-5

  16. The overlap of three fields of study may be the key to a better understanding of mental health. • The same symptomology can come from any of at least three disorders. • The key to understanding the etiology of mental illness, substance abuse, and trauma will be found in the KEY, the overlap between the three fields of study. • Mental Illness is an endogenous, physiological event. • Substance induced psychoses is an exogenous, physiologically caused event derived from excessive amounts of drugs that change the balance of the endorphin type systems. • The psychosis that can follow trauma is a normal response to abnormal circumstances. It is an endogenous, physiological event caused by exogenous events. • All three can produce the same symptoms in an affected person. COSIG Overview 3-23-5

  17. The same or similar symptomology can come from at least thee major sources • Mental Illness (MI) can result in a major depression or psychosis. • Trauma can result in a major depression or psychosis. • Substance Abuse (SA) can result in a major depression or psychosis. These among other conditions canproduce similar mental health related symptoms in a person. COSIG Overview 3-23-5

  18. All three conditions can produce similar symptomologyin humans COSIG Overview 3-23-5

  19. A New Emerging Science:The Study of the Co-occurring Disorders of MH, SA & Trauma—Unlocking the Secret COSIG Overview 3-23-5

  20. Conclusion • This COSIG Project signals the beginning of a process that is designed to integrate services for people with co-occurring disorders into the organizational structure of ODMHSAS. • The methods used in this process will empower consumers and advocates. • Most importantly, it will result in the development of a system of services that is far more effective and available to people with a co-occurring disorder than ever before in State funded mental health and substance abuse treatment facilities in Oklahoma. COSIG Overview 3-23-5

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