State Efforts to Enhance Treatment Systems for Adolescents with Substance UseCooccurring Mental Heal

1
State Efforts to Enhance Treatment Systems for
Adolescents with Substance Use/Co-occurring
Mental Health Disorders

• 2009 NIATx Summit
• and
• SAAS National Conference
• July 30, 2009
• Tucson, Arizona
• Nitika Singh, PhD
• Department of Health Services
• Division of Behavioral Health Services

2
Substance Abuse Coordination (SAC) Grant Projects
in Arizona
3
Impact of SAC Grant on Adolescent Substance Abuse
System of Care in Arizona

• Three pronged
• Better understand the strengths and needs of
  adolescent substance abuse system of care in
  Arizona
• Strengthening and improving infrastructure for
  adolescent SA treatment
• Sustaining the progress made in strengthening the
  system.

4
Better Understand Strengths and Needs of the
Adolescent Substance Abuse System of Care in
Arizona

• Statewide Focus Groups
• Financial Mapping
• Statewide Adolescent SA Treatment
  Provider/Program Evaluations

5
Statewide Focus Groups

• Major themes explored were
• How serious is adolescent substance abuse in
  Arizona?
• What EBPs are currently being practiced?
• How are treatment plans being developed and
  implemented? Specifically, are Child and Family
  Teams being used effectively?
• What resources are available to the providers and
  the adolescents and their families?

6
Financial Mapping

• To more fully understand what is a complex
  picture of multiple funding streams in order to
  better inform policy decision making
• To get a better sense of areas of strength, as
  well as areas of duplication, inefficiency, and
  gaps
• To support services that have better outcomes for
  children and families
• Discrepancy b/w behavioral health and substance
  abuse services
• High levels of funds utilized for out of home
  placements/services

7
Statewide Adolescent SA Treatment
Provider/Program Evaluations

• Quality assessment criteria included Nine
  Key Elements of Effective Treatment for
  Adolescent Substance Abuse
• Comprehensive standardized screening and
  assessment
• Comprehensive, integrated treatment approaches
• Family involvement in treatment
• Developmentally appropriate programming
• Gender and cultural competency
• Engaging and retaining teens in treatment
• Continuing care
• Treatment outcomes
• Qualified staff

8
Strengthening and Improving Infrastructure for
Adolescent SA Treatment

• Interagency Collaboration
• Family Involvement at all levels of SA Treatment
• Workforce Development
• Lead Substance Abuse Clinical Advisor Position
• Family and Youth Collaborator Position
• Substance Abuse Practice Protocol- Comprehensive
  Assessment And Treatment For Substance Use
  Disorders In Children and Adolescents

9
Interagency Collaboration

• Arizonas Childrens Executive Council (ACEC)
• Adolescent Substance Abuse Subcommittee
• The Adolescent Substance Abuse subcommittee will
  meet regularly to discuss issues pertaining to
  research and implementation of substance abuse
  services for youth and their families. The focus
  of this committee will be to review any
  initiatives, practices, and strategies that are
  identified to help strengthen and increase
  engagement and participation of these youth and
  their families in treatment. The committee will
  have cross system representation to ensure that
  the impacts of other system efforts are
  considered when services are offered to youth in
  behavioral health.
• System partners invited to all statewide
  trainings and conferences supported by the grant
• Participate and collaborate on projects initiated
  by the system partners

10
Family and Youth Involvement in all levels of SA
Treatment

• Family Involvement Center (FIC) and Mentally Ill
  Kids In Distress (MIKID)
• Required element - family members/caregivers
  should be involved at all levels of treatment
• Dare To Be Different Youth Conference
• SATISFACTION- Peoria School District Project
• Currently youth are working protocol on youth
  involvement in treatment

11
Workforce Development

• Statewide Trainings in SA EBP
• Adolescent Community Reinforcement Approach
  (ACRA)
• Matrix Model for Adolescent
• Motivational Enhancement Therapy/Cognitive
  Behavioral Therapy (MET/CBT)
• Motivational Interviewing
• White Bison Wellbriety Programs
• Circle of Strength
• CRAFT
• Seven Challenges
• Teen Intervene
• SA Screener CRAFFT

12
Substance Abuse Practice Protocol- Comprehensive
Assessment And Treatment For Substance Use
Disorders In Children and Adolescents

• Protocol has the following nine elements that
  must be incorporated into all adolescent
  substance abuse treatment programs
• Comprehensive Screening and Assessment Process
• Integrated Treatment Approach
• Family Involvement in Treatment
• Developmentally Appropriate Programming
• Gender and Cultural Competence
• Engagement and Retention of Adolescents in
  Treatment
• Treatment Outcomes
• Aftercare plans

13
Substance Abuse Practice Protocol- Comprehensive
Assessment And Treatment For Substance Use
Disorders In Children and Adolescents

• Providers will be required to implement the
  identified Service Expectations as clearly
  identified in this document

14
Sustaining the Progress made

• SAPT Funding Earmarked for Adolescent Substance
  Abuse Treatment
• Lead Substance Abuse Clinical Advisor Position
• Family and Youth Collaborator position
• Ongoing SA Treatment Program Evaluations by
  RBHAs
• Substance Abuse Practice Protocol- Comprehensive
  Assessment And Treatment For Substance Use
  Disorders In Children and Adolescents

15
Contact Information

• Nitika Singh
• (602) 364 - 4383
• singhn_at_azdhs.gov