Community Mental Health & Substance Abuse Services of St. Joseph County

Substance Abuse Prevention Services

Scope of Services

Compared to the State in general, persons in St. Joseph County experience a higher degree of socioeconomic stress. There are greater percentages of children and families with children living in poverty, higher rates of crime, higher teen birth rates, marriage and divorce rates. Not surprisingly, these and other risk factors leave St. Joseph County more vulnerable to substance abuse and related issues. The County rates below the State average on a number of general health and wellness measures such as obesity, the adult smoking rate, binge drinking, and alcohol related vehicle crashes. Substance abuse prevention services focus on reducing these high risk behaviors or indicators, and promoting healthy drug-free lifestyles.

Persons Served: The Substance Abuse Prevention Services or SAPS at Community Mental Health & Substance Abuse Services of St Joseph County or CMHSAS-SJC makes no limitations on persons served. There are three designated populations of persons served: universal, selected and indicated. Universal is the general population, anyone. A Selected population has been chosen for SAPS because they possess risk factors that make them more likely to experience substance use. Indicated populations have exhibited some degree substance use that makes SAPS “indicated” for them.

Location or Settings: CMHSAS-SJC SAPS are conducted throughout St. Joseph County. Services are done in schools, for businesses, at the County courthouse, in other service agencies and at community events. The location and/or setting of the SAPS we provide vary greatly.

Hours of Service: When CMHSAS-SJC SAPS are conducted is also highly variable; they are done on weekdays, weekends, in the morning and in the evening. The delivery of SAPS are concentrated during, but not limited by, the normal work days and hours.

Frequency of Service: Based on the type of SAPS being provided, the frequency of that service could be on a weekly basis or a one time only occurrence. For example, our ongoing SAPS group at the County jail is done every week throughout the year, while a community focus group service may happen once a year.

Payer Sources: Funding for SAPS at CMHSAS-SJC comes from the State through the Michigan Department of Health & Human Services or MDHHS, the Office of Recovery Oriented Systems of Care or OROSC, out of “block grant” funds dispersed through Southwest Michigan Behavioral Health or SWMBH, our regional coordinating agency/affiliation. From time to time, CMHSAS-SJC may receive dollars from a grant or some local sources to provide some SAPS.

Fees: There is never any charge for CMHSAS-SJC SAPS. That being said, money may be collected at an event for a catered meal or some particular item that is needed for the program or activity. This is not a profit making proposition; money is rarely collected and, if it is, it is only done to pay for food or to cover the cost of purchasing a workbook, etc., for a participant.

Referral sources: Referrals or requests for SAPS can and do come from just about anywhere. The Sherriff’s Office, the Courthouse, schools, churches, businesses, hospitals, other agencies, community organizations and individuals. CMHSAS-SJC does not limit where requests for a SAPS come from.

Services offered:

SAPS strategies fall into several categories as developed by the Center for Substance Abuse & Prevention or CSAP. The three primary or core prevention strategies are educational, community-based, and environmental. Other accepted prevention strategies (information dissemination, alternatives, and problem identification and referral) are rarely used independently and are usually allied with one or more of the core strategies. CMHSAS-SJC utilizes SAPS strategies developed or approved by CSAP.

Education Strategies

Too Good for Drugs & Violence

Too Good for Drugs or TGFD is an evidence-based prevention program for kindergarten through 12th grade that builds on students’ resiliency by teaching them how to be socially competent and autonomous problem solvers. The program is designed to benefit everyone in the school by providing needed education in social and emotional competencies and by reducing risk factors and building protective factors that affect students in these age groups. TGFD focuses on developing personal and interpersonal skills to resist peer pressures, goal setting, decision making, bonding with others, having respect for self and others, managing emotions, effective communication, and social interactions. The program also provides information about the negative consequences of drug use and the benefits of a nonviolent, drug-free lifestyle. TGFD has developmentally appropriate curricula for each grade level through 8th grade, with a separate high school curriculum for students in grades 9 through 12. The K-8 curricula is ten weekly, 30- to 60-minute lessons, while the high school curriculum is fourteen weekly, 1-hour lessons, plus twelve optional, one hour “infusion” lessons designed to incorporate and reinforce skills taught in the core curriculum through academic infusion in subject areas including English, social studies, and science/health. Ideally, implementation begins with all school personnel (e.g., teachers, secretaries, janitors) participating in a ten hour staff development program, which can be implemented either as a series of one hour sessions or as a one or two day workshop. TGFD has a companion violence prevention program, Too Good for Violence or TGFV. In high school, the two programs are combined into one program called Too Good for Drugs & Violence High School. We have utilized both programs. The expected evidence-based outcomes include: changed intentions about the use of alcohol, tobacco marijuana and the propensity to engage in violent behavior, an increase in protective factors against for substance use and violence, a decrease in risk factors for substance use and violence, an increase in healthy personal and pro-social behaviors.

Project Alert

Project Alert is an evidence-based prevention program for students in middle or junior high school that focuses on alcohol, tobacco and marijuana use. It seeks to prevent adolescent non-users from experimenting with these drugs, and to prevent youths who are already experimenting from becoming regular users or abusers. Based on the social influence model of prevention, the program is designed to help motivate young people to avoid using drugs and to teach them the skills they need to understand and resist pro-drug social influences. The curriculum is comprised of eleven lessons in the first year and three lessons in the second year. Lessons involve small group activities, question and answer sessions, role-playing, and the rehearsal of new skills to stimulate students’ interest and participation. The content focuses on helping students understand the consequences of drug use, recognize the benefits of non-use, build norms against use, and identify and resist pro-drug pressures. The expected evidence-based outcomes include: a delay in starting any substance use, a decrease in use already occurring, an increase in positive attitudes and resistance skills related to the use of alcohol, tobacco and other drugs.

Project Magic

Project "MAGIC" or PM is an evidenced based prevention program that targets juveniles/teens that are in a selected or indicated population. The purpose of PM is to teach teens skills that will help them get out of the juvenile justice system and become productive members of the community. The main thrust of the program focuses on enhancing the juvenile's basic social and interpersonal skills of positive communication, problem solving, decision making, self-responsibility, conflict resolution, goal setting and aspiration building. The program encourages community leadership and career development. CMHSAS-SJC SAPS regularly conducts PM in several schools throughout the County.

Prime For Life

Prime For Life or PFL is an evidence-based program that utilizes motivational intervention techniques to present factual information in a group setting for early intervention and/or to prevent substance use problems. PFL was initially used with court-referred impaired driving offenders and was then adapted for use with military personnel, college students, parents, middle and high school students. There are several different versions of the program, ranging in duration from 4.5 to 20 hours, which utilize optional varied activities to accommodate differing target populations.

Based on the Lifestyle Risk Reduction Model, the Trans-theoretical Model and persuasion theory, PFL emphasizes changing participants’ perceptions of the risks of drug and alcohol use and related attitudes and beliefs. Risk perception is altered through the carefully timed presentation of both logical reasoning and emotional experience. Instructors use empathy and collaboration to increase participants’ motivation to change behavior to protect what they value most in life. Participants are guided in self-assessing their level of progression toward or into dependence or addiction. PFL also assists participants in developing a detailed plan for successfully following through with their desired behavioral change. Multimedia presentations and extensive guided discussion help motivate participants to reduce their substance use or maintain low-risk choices. Individual and group activities are completed using participant workbooks. The expected evidence-based outcomes include: an increase in the perceived risk for alcoholism and/or addiction, a decrease in the intention to drink and/or use drugs, an accurate self-assessment of alcohol and/or drug-related problems, a decrease in any return to use or recidivism.

Environmental Strategies

SYNAR compliance checks

SWMBH receives federal block grant dollars through OROSC to conduct tobacco compliance checks on area vendors in order to ensure our County’s adherence to the Michigan Youth Tobacco Act and the federal SYNAR regulation. As the designated substance abuse prevention agency for our County, CMHSAS-SJC is responsible for conducting the required SYNAR compliance checks within our County as mandated on an annual basis. The procedures for these checks are outline by State and Federal regulations. A compliance rate or passing percentage of greater than or equal to 80% is expected. The process involves youth inspectors between the age of 15 and 17, while in the company of a designated adult, attempt to purchase tobacco from area vendors. Compliance checks are conducted in conjunction with vendor education for at least 10% of the total vendors in our County. The required SYNAR checks are relatively limited in scope. As the designated substance abuse prevention agency in our County, CMHSAS-SJC routinely conducts additional vendor education and compliance checks.

Alcohol compliance checks

Alcohol compliance checks are conducted in much the same way as the SYNAR tobacco compliance checks. Trained underage volunteers working with local police attempt to purchase alcoholic beverages at local stores, restaurants or bars. If the volunteer is successful in his/her attempt to purchase alcohol, the establishment is subject to certain penalties, which may include: a letter of reprimand from the County Prosecutor, a fine being reported to the Michigan Liquor Control Commission and possible revocation of their liquor license. Alcohol sales education is conducted as a part of this program. Positive recognition is given to those businesses that successfully pass the alcohol compliance check. Unlike SYNAR checks, alcohol compliance checks are not Federally or State mandated; they are conducted annually as SWMBH requires and as a part of CMHSAS-SJC SAPS underage drinking campaign.

Community Based Processes

CMHSAS-SJC SAPS sponsors and/or participates in many events that serve to disseminate substance abuse prevention information, educate the citizens of our County and identified subgroups within the community. These events include speaking engagements, participating in various “fair” events (i.e., health fairs, parenting fair, the County fair), doing presentations for local service organizations, large County employers, working through electronic and with the news media.

The Task Force

The work of educating the community at large and specific groups within the community is often carried out through the St. Joseph County substance abuse Task Force. The Task Force is one of several community work groups that are overseen by the St. Joseph County Human Services Commission. The CMHSAS-SJC SAPS specialist has the responsibility for creating, maintaining and managing the Task Force in our County. The Task Force is a collection of key stakeholders in our County who have the common goal of reducing the incidence and negative impact of substance abuse in our County. Members of the Task Force are from a variety of service agencies, public health, businesses, schools districts, law enforcement agencies, our County’s two hospitals, veterans and concerned citizens in the County. It promotes the coordination and collaboration of substance abuse prevention efforts in our County, helping to identify substance abuse issues in our County, gaps in service, issues and populations in need of SAPS. The Task Force advocates for community level change(s) that help reduce the risk factors for substance abuse and increase the protective factors against substance abuse. It focuses on increasing the public awareness of our County’s substance problem(s) through specific presentations, trainings, and the development/implementation of activities or campaigns aimed at the entire County and its significant institutions.

Special Populations:

The CMHSAS-SJC SAPS program provides programming for several indicated populations in our County. Participants in these programs are chosen to receive SAPS based on indentified current or recent substance use/abuse issues.

Those with correctional involvement/in our County jail: CMHSAS-SJC SAPS provides an open PFL group for men and women in our County jail. The weekly groups are held separately, a men's group and a women's group, for those identified/known to have a history of substance abuse problems, alcohol/drug related arrest/conviction and who express a desire for “help” with their substance abuse issues. These groups are voluntary and seek to educate some of the most disaffected in our County.

Parents in recovery: the Strengthening Families or SF program is being implemented by CMHSAS-SJC SAPS to address substance abuse within families where one or both parents are in recovery. SF is an evidence based prevention program designed to impact the family system, creating pro-social healthy family functioning that is resilient and resistant to the substance abuse. A parent who is in substance abuse treatment with CMHSAS-SJC is invited to participate in SF. Participant families may be referred through local schools, our County's Juvenile/Probate Court and/or the MDHHS/Child Protective Services. This program is being implemented as a part of a SWMBH/State/Federal grant called Partnerships For Success and is just getting under way.

Juveniles involved in the criminal justice system: Minors who have been arrested/convicted of use and/or possession of alcohol and any other substances of abuse are routinely referred by the juvenile court to CMHSAS-SJC for SAPS. Monthly Saturday youth focused PFL groups are conducted as an early intervention prevention strategy.