Building Family Focused Substance Abuse

1
Building Family Focused Substance Abuse Mental
Health Treatment Systems

• Norma Finkelstein, Ph.D.
• Institute for Health Recovery
• CMHS / U-Mass Meeting
• November 15, 2001

2
IHR

• History of systems work with providers, community
  groups, state agencies
• Outside agency can sometimes transcend turf
  issues
• Central state resource for family focused care in
  substance abuse

3
Systems Change Work Requires Identification of

• Service gaps
• Common goals and objectives
• Challenges / barriers
• Facilitators / resources
• Key stakeholders
• Community resources supports

4
Goals

• Integrate children parenting into a parents
  assessment treatment
• Address parenting role provide specific
  parenting services
• Pay attention to address childrens
  developmental mental health needs
• Recognize that family treatment prevention

5
Challenges / Barriers

• Individual treatment approaches
• Disease model
• Mentally ill women dont have children
• Attitudes
• Stigma low social tolerance of addiction /
  mental illness in mothers
• Anger and blame from caregivers

6
Challenges / Barriers

• Turf conflicts
• Parenting seen a Child Welfare issue
• Substance abuse is treatment for adults only

7
Challenges / Barriers

• Funding / Reimbursement
• Acknowledgement greater funding
• Parenting seen as educational not
  treatment not medically necessary

8
Challenges / Barriers

• Providers fear of being asked to do something
  new without sufficient support / resources
• Staff education, training, supervision
• Lack of knowledge of community resources
• Lack of coordination of care

9
Systems Change

• Recognize slowness of systems change
• Start small demonstrations, pilots
• Begin to address specific barriers
• Build collaborations with key stakeholders,
  including consumers

10
Systems Change

• Start with RESPECT, building bridges,
  communication
• Example Values clarification
• Create environment that encourages, facilitates,
  inspires people to engage in systems change
• Relational / collaborative
• Move pilots into institutionalization

11
IHR Examples

• Parenting services
• CSAP / PPWI Nurturing Program
• Statewide Implementation
• Residential
• Outpatient - Reimbursement

12
Strategies Used

• Engage BSAS Director Assistant Director in
  discussions education
• Engage BSAS / DMA / MBHP in statewide task force
• Conduct needs assessment of providers survey
  telephone interviews
• Present needs assessment to BSAS leadership

13
Strategies Used

• Develop concept paper at request of BSAS on
  payment for parenting qualifications of
  providers recommended curriculums, etc.
• Utilize other state agency discussions of
  importance of parenting to impact BSAS / DMA /
  MBHP
• Provide training to managers, providers, central
  office staff

14
Policy Outcomes

• Agreement to fund parenting groups
• Notice sent to outpatient providers of intent to
  fund parenting
• Meeting held with DMA on issues
• Work now on eligibility, provider requirements,
  rates

15
Childrens Services

• Child care / childrens mental health committees
• Cross system work DSS, DMH, OCCS, DPN
• Task forces, round tables, forums
• Have Toys Will Travel
• OCCS, EI, DPH collaborations
• DMH DPH collaborations
• WELL Child