Mental Health and Substance Abuse Services Joe Vesowate Assistant Commissioner

Page 2 Organizational Structure

Page 3 Division Summary Substance Abuse Prevention, Intervention, and Treatment Services Inpatient Psychiatric Services Community-Based Mental Health Services Projects for Assistance in Transition from Homelessness (PATH) NorthSTAR – Community-Based Mental Health, Substance Abuse and Co-Occurring Services South Texas Health Care System Texas Center for Infectious Disease (TCID)

Page 4 Substance Abuse Prevention and Early Intervention Services Primary Prevention HIV Early Intervention and Outreach Outreach, Screening, Assessment and Referral Services (OSAR) Tobacco Prevention and Control Pregnant and Post-partum Intervention for Women (PPI)

Page 5 PREVENTION OUTCOMES Outcomes Positive among Youth in DSHS-Funded Substance Abuse Prevention Over Time Source: DSHS Behavioral Health Integrated Provider System (BHIPS). Percent of Youth Completing SA PreventionNumber of Schools Participating in SA Prevention

Page 6 PREVENTION OUTCOMES Percentage of Texas Youth Who Used Substances in the Past Month Decreasing Over Time Source: Texas School Survey of Substance Use, DSHS.

Page 7 Substance Abuse Treatment Services Detoxification Intensive and Supportive Residential (adult and youth) Outpatient (adult and youth) Opioid Replacement Therapy Co-Occurring Psychiatric and Substance Abuse Disorders (COPSD) Services Specialized Female Services

Page 8 TREAMTMENT OUTCOMES Clinical Outcomes Positive among Adults Completing DSHS-Funded Substance Abuse Treatment Over Time Source: DSHS Behavioral Health Integrated Provider System (BHIPS).

Page 9 TREATMENT OUTCOMES Clinical Outcomes Positive among Youth Completing DSHS-Funded Substance Abuse Treatment Over Time Source: DSHS Behavioral Health Integrated Provider System (BHIPS).

Page 10 Current and Emerging Challenges Increase in methamphetamine use Emergence of “Cheese” Heroin usage by youth Changing trends in use patterns Cost pressures on treatment providers Workforce development Availability of specialized services Ensuring a continuum of care and appropriate use of clinical information

Page 11 DRUG USE TRENDS Cocaine and Alcohol Decreasing, while Marijuana, Methamphetamines, and Opioids Increasing as Primary Substances for Which Adults Seek DSHS-Funded Substance Abuse Treatment Source: DSHS Behavioral Health Integrated Provider System (BHIPS).

Page 12 DRUG USE TRENDS Alcohol Decreasing while Marijuana Increasing as Primary Substances for Which Youth Seek DSHS-Funded Substance Abuse Treatment Source: DSHS Behavioral Health Integrated Provider System (BHIPS).

Page 13 Partnerships and Stakeholder Engagement Texas Education Agency (TEA) Education Service Centers (ESC) - expanding role of School Health Specialist to include MH promotion and substance abuse prevention efforts Legislative direction to implement tobacco education program in schools Drug Demand Reduction Advisory Committee (DDRAC)

Page 14 Partnerships and Stakeholder Engagement (cont’d.) Rural Border Initiative (RBI) Provides substance abuse services in Health & Human Service Regions 8, 10, and 11, covering 15 counties (including Colonias) Creates and expands service linkages along a continuum of substance abuse prevention, intervention, and treatment, while at the same time strengthening individuals, families and communities through mobilization and empowerment. Utilizes trained community members as volunteers and mentors, and have significantly increased the use of Community Health Workers (Promotores), trained outreach workers from the target population. Created alliances with HHSC’s Colonias Initiative, DSHS’ Office of Border Health, and Texas A&M University (TAMU) Colonias Projects (CHUDs).

Page 15 System Improvement Clinical Management Behavioral Health System (CMBHS) Access to Recovery (ATR) Screening, Brief Intervention, Referral, and Treatment (SBIRT) Crisis Counseling Program Initiatives Substance Abuse Services Performance Improvement Actively seeking new funding opportunities

Page 16 Clinical Management Behavioral Health System (CMBHS) Integrated clinical management tool for Substance Abuse and Mental Health service providers Capture demographic, service and clinical data for Substance Abuse and Mental Health clients Track service utilization and client progress Facilitate State and Federal reporting requirements

Page 17 Access to Recovery (ATR) Federal SAMHSA Grant awarded 2004 $22.8 million for three years Federal target 8,928 clients; served 15,000 Voucher issued to client rather than contract with provider 30 participating drug courts in 13 counties Second ATR Meth Grant awarded 2007 $13.5 million for three years Federal target 6,038 clients Focus on methamphetamine use Partnership with Governor’s Office/Criminal Justice Division

Page 18 Screening, Brief Intervention and Treatment (SBIRT) Federal initiative designed to integrate screening, brief intervention, and referral treatment services for substance abuse problems into routine delivery of medical care Creates bridge between general medical system and the substance use disorders delivery system

Page 19 Crisis Counseling Program Initiatives Ensuring comprehensive disaster response and recovery plan by integrating substance abuse into State’s Disaster Behavioral Health Plan Collaborating with substance abuse OSAR centers to ensure that substance abuse services remain consistent during and after a disaster Providing easier access to community resources that will significantly enhance delivery of crisis counseling services following disasters

Page 20 Substance Abuse Services Performance Improvement The Texas Recovery Initiative (TRI) Partnership between DSHS and the substance abuse treatment and recovery communities Identify opportunities and methods for improving the quality and effectiveness of services provided to adult population Process will consist of a series of community meetings, creation of a task force and the presentation of a set of summary findings for service improvement and recommendations