The Behavioral Health Alliance of Rural Pennsylvania (BHARP) TREE Project will improve substance use and behavioral health outcomes for transition age youth, 18 to 25 years of age, who have a substance use disorder (SUD). This will be accomplished by creating a continuum of services from emergency departments (EDs) or other crisis-based services to effective behavioral health treatments with a primary focus on enhancing/creating peer-based services.
Two overlapping peer-based interventions will be used to bridge the gap between crisis and treatment for young adults with a SUD in the rural region of the proposed project. Certified Recovery Specialists (CRS), who are in recovery from a SUD and Certified Family Recovery Specialists (CFRS), who are family members of a loved one with a SUD, will be the primary vehicle to integrate treatment, family support, and access to recovery capital for the target population. Individuals with an Opioid Use Disorder (OUD) and at high risk for an overdose, with or without a co-occurring mental illness, will represent the largest target group. Therefore, access to rapid medication assisted treatment will be one of the essential outcomes of the project..
Five BHARP member Counties will implement the project with the intent to expand the project to the remaining 18 BHARP counties. CRS and CFRS will engage young adults and their families in local EDs and transfer them to addiction treatment services. CRS staff will be trained to use a collaborative engagement protocol, being developed in another SAMHSA grant, to educate young adults with a SUD about effective treatments for OUDs & other SUDS, including medication assisted treatment. CRS will work with CFRS staff and the target population to integrate the person’s families in the treatment planning process.
The primary goals are to effectively engage individuals in the ED and retain them in a continuum of care across the rural landscape for 6 or more months. Several evidence-based interventions, beyond the peer staff, will be used to increase engagement and retention, including the use of the community reinforcement approach (CRA) for addiction treatment, which includes versions for treatment providers, family members (CRA-FT) and peers. The CRA framework will be used to increase family involvement while simultaneously increasing the target populations access to rewarding, recovery-based activities. The SAMHSA toolkit for smoking cessation will also be used to accurately screen the target population for tobacco use disorder (TUD), provide motivation to quit, and expand access to smoking cessation medications.
Fifty transition age youth will be served in the first year of the project and one hundred will be served in years two through five. The overarching outcome is for 65% of target population to be enrolled in addiction treatment in year one with a 20% increase in years two through five and retain the target population in a continuum of care, starting at the ED or other crisis setting for six months in years one through five. Other outcomes include expanding access to MAT for SUDs and increasing the percentage of families who are involved in the person’s treatment.