Studying Substance Use Disorders and Mental Health services in the Bronx using a Health Disparities Research Approach - Using a health disparities (HD) research framework, the goal of this project is to study the individual, interpersonal, community, and societal factors associated with the use of health care services for substance use disorders (SUD) and mental health (MH) in the Bronx, NY. The ultimate health outcome is to reduce fatal and non-fatal overdoses. Intermediate outcomes of the study include, but are not limited, to those related to understanding access and adherence to treatment to SUD and MH services; coordination between SUD and MH services in the Bronx; knowledge and enrollment in CMS-related insurance programs; patterns of usage of services; and types of social support structures available in the Bronx that encourage or discourage healthy lifestyle behaviors, among others. This project will explore specific gaps in knowledge that exist among populations that have been traditionally excluded in research and practice and who experience health disparities in SUD. These include sexual and gender minorities, low-income, urban-marginal, immigrants. and racial and ethnic minorities. The project's aims were explicitly designed to promote community and clinical linkages and promote cultural responsiveness of SUD and MH health in the Bronx. The project's innovation is in using information and data from multiple stakeholders and methods to study the patterns of use of health services for SUD and MH issues and barriers to use and long-term engagement in treatment. This project convened an interdisciplinary research-clinical expert team of investigators from a higher education research institute (Lehman College a Minority Serving Institution - CUNY's Institute of Health Equity) and a local Health System (BronxCare). A total budget: $254,686 will cover activities for the following aims: - AIM 1: Convene Bronx Community Taskforce with health services providers across the Bronx to explore factors associated with the utilization of mental health and substance abuse disorder services, including but not limited to the study of barriers to access and cultural responsiveness of services - AIM 2: Conduct a rigorous assessment of the availability of mental health and substance abuse services using public Federal, State, and City data, and the associated factors that predict use or underuse by zip code and for specific populations that experience higher health burdens of substance abuse and mental health disorders - AIM 3: Conduct a qualitative investigation of adult patients of the outpatient addiction services program at BronxCare of their distinctive health characteristics and attributes, behaviors, and other factors that influence their healthcare utilization, including within-group or sub-group comparisons; and a quantitative review of insurance claims data. Ultimately, this project seeks to meet CMS's goal to close the gaps in healthcare access, improve the quality of services, and reduce the health disparity in SUD and MH disorders.
