Building on Westchester County Department of Community Mental Health (DCMH) Co-Occurring System of Care efforts that began in 2017, and in collaboration with six key behavioral health providing organizations that have been leaders in transforming integrated care to meet the needs of the target population, DCMH proposes to enhance and expand comprehensive treatment, early intervention, and recovery support services for adolescents (ages 12-18) and transitional aged youth (ages 16-25) with substance use disorders (SUD) and/or co-occurring substance use and mental health disorders (COD), and their families/primary caregivers. The COSOC-TREE project will serve an average of 226 new clients during each year of the 5-year grant period for a total of 1,132 clients altogether. The county is 65.4% White, 24% Hispanic or Latino; 14.6% Black; 5.9% Asian; and 13.7% two or more or other races. However, there are profound socioeconomic disparities between Blacks and Hispanics in comparison to Whites. Nonetheless, non-Hispanic Whites are twice as likely to die from opioids as non-Hispanic Black and Hispanic populations.
Focusing on COD, the COSOC-TREE project will apply a much-needed wraparound approach by employing Encompass, an evidence-based practice (EBP) which integrates the treatment of substance use disorders and co-occurring psychiatric disorders in adolescents and transitional aged youth through MET/CBT + CM. Encompass embodies the integrated treatment principles for people with COD which have demonstrated superiority to nonintegrated approaches and helps to improve substance use, mental illness symptoms, treatment retention, cost effectiveness, and client satisfaction. This approach wholly aligns with SAMHSA best practice recommendations for truly integrated or concurrent treatment of SUD and co-occurring psychiatric disorders (SAMHSA TIPS 42, updated March 2020). The project will be enhanced by the inclusion of Community Reinforcement Approach and Family Training (CRAFT), which is a multi-session EBP for concerned significant others (CSOs), i.e., family members, caregivers, friends. The overarching goals of CRAFT are to improve the lives of CSOs, reduce the problematic addictive behavior of the identified patient (IP), and increase the IP's motivation to enter treatment. CRAFT bolsters family/CSO involvement working synergistically with Encompass. A train-the-trainer component for eligible clinicians certified in Encompass and/or CRAFT will aid in sustainability and growth. To increase youth and family engagement, and taking into account ancillary needs and provider expertise, the Youth Service/Recovery Support Coordinator will be utilized to receive referrals and use motivational enhancement approaches in evaluation of potential participants to ensure seamless navigation to the best-fit COSOC-TREE provider(s).
Project Goals: decrease youth mental illness and substance use by increasing identification and treatment of co-occurring disorders (COD) in the target population; improve treatment options and outcomes and the accessibly of comprehensive services to a larger number of unduplicated youth clients than are currently being served; provide prevention education and messaging, via social media and in-person presentations, on COD, raising Co-Occurring Disorders Awareness (CODA), and making healthy choices that include no use of any substances; and, increase the participation of concerned significant others (CSO) (i.e., parents, grandparents, partners, etc.) in the treatment of individuals (adolescents and transitional aged youth) with COD and SUD.
