Nearly 200 people die every day from a drug overdose. Millions more struggle with addiction. Addressing the needs of individuals and families affected by substance use and its consequences requires the coordinated involvement of professionals from across the continuum of care—substance misuse prevention, treatment, and recovery. Yet despite the fact that these professionals share common goals, frequently see the same clients, and more often than not work within the same agencies, differences in training, perspective, and terminology can create artificial barriers to effective collaboration.
Such was the case in Virginia’s Hanover County Community Services Board (CSB)—a full-service agency that provides prevention, treatment, recovery support, and crisis management related to mental health, substance use, and developmental disabilities. Despite CSB’s commitment to providing a seamless menu of services, staff working across the agencies’ multiple departments knew little about how their services connected and/or how they might work together to better serve their clients.
To support more effective collaboration, Dr. Gabriella Caldwell-Miller, the CSB’s new division director of behavior health and wellness, reached out to Prevention Solutions@EDC.
“After working at the state level, Dr. Caldwell-Miller recognized the potential for enhanced collaboration across departments,” said PS@EDC’s Jessica Goldberg. “She saw the importance in having staff know and understand what others were doing, and where there were synergies to support one another and the people they serve.” Together, Caldwell-Miller and Goldberg planned two days of programming—a training for CSB behavioral health staff followed by an action-planning session for the behavioral health and wellness leadership team.
Eighteen CSB staff members attended the day-long training, representing all sectors of the continuum of care—prevention practitioners, treatment providers, recovery coaches, and crisis managers. The group began by defining key terms, acknowledging that terminology familiar to one sector might be foreign to another.
“Prevention practitioners are comfortable speaking the language of risk and protective factors; treatment providers the language of recovery capital. For people to connect, they need to speak the same language,” said Goldberg.
The group also looked at how language can influence our perceptions of people with substance use disorders, and in turn, reduce access to care.
Terms such as “abuse,” “drug habit,” and “addict” can negatively affect judgments about people who misuse substances,” said Goldberg. “We know from the research that people view individuals with substance use disorders more negatively than people with physical or psychiatric disabilities. Often the shame and concerns people feel about disclosing a drug problem keeps them—and their families—from seeking the help they need.”
The training also examined the National Academy of Medicine’s Continuum of Care, a framework that presents the scope of behavioral health services individuals need before, during, and after they experience a behavioral health problem or disorder.
“The beauty of the IOM is that it underscores the interrelationship among promotion, prevention, treatment, and maintenance,” says Goldberg. “While some services may be more specific, individualized, or costly than others, it shows how each phase along the continuum is connected. The elements do not—and cannot—exist in isolation.”
As the group discussed the model, many cross-sector similarities emerged. Despite differences in payment structure, licensing, and audience (prevention tends to focus on populations and environments; treatment and recovery on individuals), all sectors relied on evidence-based approaches, were guided by ethical standards, engaged people who were at risk, and recognized the importance of mobilizing supports throughout the community.
As participants became more familiar with one another’s work, opportunities for collaboration also became apparent. Treatment providers realized they could turn to the prevention partners for help accessing prevention programs for their clients’ children. Recovery coaches began considering ways to connect with prevention and treatment providers to better support the survivors they visited post-overdose. All agreed that knowing how other fields work, and the resources each had to provide, was key to helping their clients and their families better navigate the continuum of care.
Following the training, members of the agency’s behavioral health leadership team participated in a half-day, facilitated brainstorming meeting. The group first generated a “wish list” of ways to better integrate their work, then prioritized concrete steps for operationalizing their ideas.
“Their enthusiasm was infectious,” said Goldberg. “Once the possibility of collaboration became a reality, the whole team was on-board, eager to apply everything they’d learned the previous day.”
Feedback on the two-day event was universally positive.In written evaluations, participants especially appreciated having the opportunity to share the experience with their ‘partners across the aisle’. “I developed a new respect for the work they’re doing and a clearer understanding of where our work intersects,” reported one participant. “I’m looking at our connectedness in a different, more positive way.”
To learn more about our work supporting collaboration across the continuum of care, contact Jessica Goldberg at firstname.lastname@example.org.