Centerstone’s Nashville-Davidson County Integrated Community Services (NDCICS) will expand the local infrastructure to integrate behavioral health treatment, increase enrollment in permanent housing that supports recovery, and provide other critical services for 260 individuals, youth, and families (Yr 1: 30; Yr 2: 50; Yrs 3, 4, and 5: 60 annually) who experience homelessness and have substance use disorders or co-occurring disorders in Davidson County, Tennessee.
Nashville-Davidson faces challenges of socioeconomic disparities (e.g. poverty, affordable housing scarcity) that contribute to homelessness. The Davidson 2016 Point-in-Time (PIT) count identified 2,400 homeless individuals and 2,200 homeless households; they are predominantly male (78%) and White (55%); 8% are children. Chronically homeless individuals/families double that of the state (40.2% vs 20%, respectively). Of local homeless persons, 21% experience chronic SUD; 5%, HIV/AIDS; and 24.5%, severe mental illness. Nearly 10% are victims of domestic violence and 9.7% are Veterans. Many Veterans in Davidson are vulnerable; 7.6% live below poverty and 27% have a disability. The county’s low income areas are designated Medically Underserved and Health Professional Shortage Areas in primary care and mental health. The overall poverty rate is 17.1%, higher than both state (16.7%) and national rates (14.7%).
NDCICS will develop/expand a community infrastructure that integrates behavioral health treatment, increases placement in permanent housing that supports recovery, and provides other critical services and support systems in Nashville-Davidson. Using all components of SAMHSA’s Treatment Improvement Protocol (TIP) 55, NDCICS will provide assertive outreach/engagement, screening/assessment/treatment, permanent housing placement, case management, employment assistance, and recovery support services for participants. Project staff will assist participants enroll in Medicaid/VA/other benefits and link them to local resources for supportive services. NDCICS will implement TIP 55’s recommended integrated strategies/interventions (e.g., treatment/prevention planning, recovery management) and evidence-based treatment/services (Critical Time Intervention, Motivational Interviewing, Trauma-focused Cognitive Behavioral Therapy, Supported Employment, Supportive Housing, augmented by Assessment-based Treatment for Traumatized Children: A Trauma Assessment Pathway). A Steering Committee of stakeholders and focus population members will support NDCICS goals and objectives to achieve the following outcomes: (1) Reduce substance abuse, mental health symptomatology, and service/ utilization costs; (2) Increase insurance/Medicaid/VA/other benefits enrollment; (3) Increase placement in permanent housing that supports recovery, employment, and independent living skills; (4) Develop/Disseminate a service model for replication. Key project partners include Nashville-Davidson Metropolitan Homelessness Commission, housing agencies, youth- and Veteran-serving agencies, health department, etc. Evaluation will be conducted by staff experienced in homelessness and SUD/COD, and all GPRA requirements will be met.