JUSTICE Project-- Justice-involved and UnderServed: Treatment Integration & Community Empowerment Project - The JUSTICE Project (The Justice-involved and Under-Served Treatment Integration and Community Empowerment Project) will expand and enhance Places for People's (PfP) Certified Community Behavioral Health Organization (CCBHO) services to address acute barriers to accessing behavioral health care, particularly for criminal justice system-involved and/or un- or underinsured adults and youth. We serve adults with Serious Mental Illness (SMI), Substance Use Disorder (SUD), Cooccurring Disorder (COD), as well as children and adolescents with Serious Emotional Disturbance (SED) and their families living in St. Louis City and County, Missouri. We anticipate that clients will identify mostly as African-American (65%), male (50%), and will be diagnosed with a range of primary diagnoses, i.e., mood/affective (35%), schizophrenia spectrum (30%), substance use (20%), and anxiety and stress-related (15%) disorders, with about 40% with COD. We will serve criminal justice-involved populations, veterans, and other adults and children who are unable to access the needed and clinically appropriate services. Given the community, behavioral health service needs described above for adults and youth with SMI, COD, SUD, or SED, especially around access to care, improving the capacity to manage symptoms, and securing needed resources to remain retained and flourishing within the community, our project has three goals, each of which builds from the previous one. We will (1) deliver an expanded array of EBPs to 605 unduplicated persons through the following services: (a) outreach and engagement to 138 persons (Y1 = 76, Y2 = 51), linking them to agency or community-based EBPs (e.g., ITCD, IPS, IMR, ACT), (b) Critical Time Intervention for 138 criminal justice-involved persons (Y1 = 83, Y2 = 55), (c) evidence-based prescriber, psychological, and/or substance use counseling services (i.e., DBT, CPT, CBT, Seeking Safety, TF-CBT, ITCD, CRA) for 310 adults and youth (Y1 = 186, Y2 = 124), and (d) direct linkage to Assertive Community Treatment to 30 persons (Y1 = 18, Y2 = 12) with the most severe impairments in psychosocial functioning and chronic institutional involvement. (2) Improve psychosocial functioning to reduce the risk of recidivism, as measured by the following objectives: (a)¿reduce the severity of mental health symptoms, particularly related to psychosis and post-traumatic stress, as indicated by decreased Brief Psychiatric Rating Scale-Expanded (BPRS-E) and PTSD Checklist for DSM-5 (PCL-5) scores and (b) reduce the severity of substance use, a indicated by decreased frequency of use measured in the Cross-cutting Symptom Measure for DSM-5, Alcohol and Drug Use Scales for DSM-5¿and higher engagement in treatment as rated by the Substance Abuse Treatment Engagement Scale. (3) Promote¿retention in the community, i.e., free from institutionalization (hospitals, jails) and engaged in productive and meaningful activities, as indicated by (a) reduced incidence of arrests, (b) reduced number of nights in jail, (c)¿successful completion of probation/parole, (d) increased access to resources (jobs, entitlements), and (e) strengthened social relationships.¿
