ESM Oakland County CCBHC IA Grant SM-22-012 will improve and enhance comprehensive integrated care in Oakland County, MI through multidisciplinary team-based care and care pathways for people in crisis, with depression, using substances or tobacco, with comorbid conditions related to eating disorders and obesity, at high risk for suicide, and/or with trauma. Evidence-based practices, training and therapies, coupled with expanded staff, will increase community based mental health services to 3,962 unduplicated individuals over four years (Y1 973, Y2 836, Y3 949, Y4 1204). Multidisciplinary team-based care increases the volume and effectiveness of screening, assessment, and care coordination for complex, co-morbid cases. Populations of focus are adults, older adults, youth, people experiencing homelessness, and armed services/veterans.
Project goals derive from Oakland County (OC) community needs assessments and target vulnerable populations including youth at risk for suicide, armed services/veterans and people experiencing homelessness exposed to trauma, and families with substance and tobacco use and/or trauma. The goals are: 1) Increase and enhance same day access to care in Adult and Family Services programs. 2) Expand community outreach and increase access to services for high-risk populations. 3) Increase suicide prevention and suicide treatment pathways for youth under the age of 18. 4) Identify individuals with co-morbid health conditions of eating disorder (youth) and adults with 30+ BMI for treatment. 5) Enhance substance use prevent, early intervention and smoking cessation programming for youth, families, and adults. 6) Enhance behavioral health, substance use, and trauma services for armed services/veterans.
OC includes 60,000 armed services/veterans, and its citizens identify as 75% Caucasian, 13% African American, 7% Asian and 4% other. Four percent (4%) identify as Hispanic or Latino. OC is 51% female and 49% male. Youth are 23% of the population, people aged 20-55 are 46% and the balance, 37% are older adults. While OC has an overall 9% poverty rate, cities such as Pontiac and Waterford have poverty rates above 11%. Tobacco users are 30% of the population, which is nearly double the adult smoking rate of 18.7% for the state of Michigan. In FY2021, ESM identified 2,481 individuals with a substance use disorder diagnosis and 1,992 adult individuals reporting experiencing trauma. Over 35% of residents living in Ferndale, Hazel Park, Lathrup Village, Madison Heights, Pontiac, Oak Park, and Southfield lacked access to sufficient primary care and mental health services.
Anticipated outcomes include: a 15% reduction in lobby wait time for adult services same day intakes, a 40% increase in available walk-in hours for Family Services Program, a 20% reduction in days between request for service and intake appointment, an increase coordination and engagement activities by 15% for individuals located at homeless shelters and substance use residential facilities, a 15% increase intakes completed at homeless shelters, a 20% decrease in days from substance use residential facility discharge to intake, expedited service requests for individuals who are experiencing homelessness and/or in a substance use in residential facilities, a 15% decrease in the number of days between identification of high-risk for suicide status and first contact with a Behavioral Health Clinician, expanded suicide prevention and treatment, DBT therapy for 40 youth and families annually, eating disorder team-based care clinic for 25 youth annually, the development and implement of a team-based care pathway for youth and families with substance use concerns, substance use treatment to 40 youth annually, and transdisciplinary assessments to 100 youth annually.