Casa Esperanza Inc.’s proposed “CasaCare-OBOT: Office-Based Opioid Treatment for Latinos with Co-Occurring Disorders” program will reduce illicit opioid drug use and related overdoses for individuals with co-occurring opioid use and mental health disorders (CODs) by expanding access to MAT and using IDDT to provide integrated culturally-competent and trauma-informed substance use disorder and mental health treatment and related recovery support services, as well as on-site primary care services. CasaCares’ goals are: 1) Expand access to MAT for Latinos with co-occurring disorders; 2) Improve access to integrated mental health, opioid use treatment, and primary care for Latinos; 3) Provide case management services to support clients’ full engagement in the development, implementation and completion of goals in their care plan; and 4) Provide recovery support services to help increase knowledge of community resources; increase capacity for self-management; and identify and reduce risky behavior. Over 5 years, CasaCare-OBOT will serve 340 individuals (40 in YR 1; 60 in YR 2; 80/year in YRS 3-5).
Our patients often lack the life skills, interpersonal skills, and health literacy necessary to keep appointments, communicate effectively with providers, and stay connected to care. Monolingual Spanish speakers and Latinx with limited or no English represent 80% of our current patients, 95%) are homeless or under-housed, and 71% have received prescribed medications for psychological/emotional problems. Only 31% received prior treatment for mental health. Of these, 98% meet criteria for serious mental illness; 95% have a PTSD diagnosis; 55% report recent depression, 61.4% report recent anxiety, 15% report recent thoughts of suicide, and 3% recently attempted suicide. All struggle with social determinants of health such as linguistic barriers, poverty, involvement with the criminal justice system, and chronic medical conditions. This places our patients at greater risk of relapse and overdose.