Virgin Islands Turning Point – Expanding Integrated Residential SUD/COD Treatment in the U.S. Virgin Islands - WestCare’s The Village – Virgin Islands Partners in Recovery (VIPIR), the territory’s only long-term residential behavioral health provider, proposes the Virgin Islands Turning Point project to expand trauma-informed, evidence-based treatment for adults (18+) with substance use and co-occurring disorders (SUD/COD) across the entire U.S. Virgin Islands. Leveraging over 30 years of experience and backed by the national WestCare Foundation, VIPIR combines deep local trust with national administrative and clinical infrastructure. As a U.S. territory prioritized under this SAMHSA funding opportunity, the Virgin Islands face significant structural barriers to behavioral health access. VIPIR receives referrals that far exceed its 25-bed capacity, with a standing waitlist and no other residential alternatives. Turning Point will close critical access gaps by expanding residential treatment capacity and layering in peer support, harm reduction, suicide screening, and psychiatric services. Population of Focus: Adults aged 18+ residing in the U.S. Virgin Islands with SUD/COD, particularly those who are uninsured, underinsured, justice-involved, or at high risk of overdose. The USVI is 76% Black or African American, 18% Hispanic/Latino, and 22.8% of residents live in poverty. Over 20% of households speak Spanish or French Creole at home. Although national surveillance systems like NSDUH exclude the USVI, available indicators point to high unmet need: the penetration rate for publicly funded behavioral health services is just 4.86 per 1,000—nearly five times lower than the U.S. average of 24.6 per 1,000. This limited access, compounded by workforce shortages and geographic isolation, drives the urgency of this proposal. Strategies and Interventions: Turning Point will deliver a culturally responsive continuum of services anchored in trauma-informed care and person-centered planning. Core interventions include residential SUD treatment grounded in CBT, Motivational Interviewing, and Seeking Safety; suicide risk screening using the Columbia-Suicide Severity Rating Scale; and peer recovery support services throughout the care pathway. Harm reduction will be integrated through education and distribution of naloxone and fentanyl test strips. Tobacco cessation, case management, and discharge planning are embedded in the daily schedule, while COD treatment will be coordinated via VIPIR’s long-standing partnership with Frederiksted Health Center. Allowable activities such as reentry support, housing navigation, and HIV/HCV education further strengthen the model’s relevance and responsiveness. Goals and Measurable Objectives: • Serve 80 unduplicated clients over 3 years (Year 1: 25; Year 2: 30; Year 3: 25) • 75% of clients will complete treatment • 80% of completers will be substance-free at 6 months and discharge • 70% will show and maintain reduced trauma and mental health symptoms • 80% of tobacco users will reduce or cease use • 80% of completers will attain employment, education, or vocational engagement
