PURPOSE
To outline and describe the provision of substance abuse prevention (SAP) services provided by Community Mental Health & Substance Abuse Services of St. Joseph County (CMHSAS-SJC) in St. JosephCounty.
DEFINITIONS
Evidence Based Practices (EBPs):EBPs are SAP services or programs that have been developed through research and have demonstrated positive, effective impact and change on an identified problem. They are programs based on change theory, possess a clear logic and conceptual model, uphold accepted scientific standards and have completed reviews by qualified researchers and practitioners. EBPs are programs registered on the Substance Abuse and Mental Health Services Administration’s (SAMHSA) National Registry of Evidenced-based Programs and Practices (NREPP) registry. CMHSAS-SJC, with Southwest Michigan Behavioral Health (SWMBH) and the Michigan Department of Community Health (MDCH), Office of Recovery Oriented System of Care (OROSC) endorse/require the use of EBPs. At least 90% of all SAP services and programs utilizing block grant and state funding must be EBPs. (Any exception to this will reviewed and approved on annual basis by the regional SWMBH SAP coordinator.)
Substance Abuse Prevention (SAP):SAP services are an array of interventions, programs, and planned actions/activities designed to address personal factors and environmental conditions that affect or contribute to the use and abuse of addictive substances. The purpose of SAP services is to delay, avert/prevent and mitigate, manage and/or reduce the use of substances that lead to development of substance abuse and addiction disorders.
Recovery Oriented Systems of Care (ROSC): ROSC is a system designed to utilize an integrated approach to a continuum of services in order to support an individual’s journey toward recovery and wellness by creating and sustaining networks of formal and informal services and supports.The opportunities established through collaboration, partnership and a broad array of services promote life enhancing recovery and wellness for individuals, families and communities.”
POLICY
SAP services provided by CMHSAS-SJC are a result of data-driven assessment of needs, effective planning, the development and implementation of specific initiatives to identify and reduce individual, family and environmental risk factors associated with substance abuse, at the same time, increasing protective factors that enhance the health and wellness of individuals, families and communities utilizing EBPs. SAP services are guided by evaluation of outcomes, collaborative efforts with strategic partnerships in the community, high ethical standards and culturally responsive interventions. SAP services are designed to be proactive in nature and comprehensive in scope.
SUBSTANCE ABUSE PREVENTION SERVICE PLANNING & DELIVERY
Guiding Principles
To ensure effective planning and implementation of SAP services, the following guiding principles will be used in the selection and utilization of prevention programming/ services; services will:
- Be research or science-based - EBPs
- Be responsive to identified community needs
- Involve key community stakeholders
- Require meaningful collaboration with strategic community partners
- Be age, gender and culturally responsive/competent
- Follow all standards set by the regional prevention coordinator through SWMBH
- Work within a ROSC approach towards wellness
Substance Abuse Prevention Planning
Annual Prevention Planning:CMHSAS-SJC SAP services will be developed and reviewed on an annual basis. An Annual substance abuse Prevention Plan (APP) will be created that will contain an outline of programs to be used, the scope of services to be provided and a list of scheduled activities that are to be accomplished in the up coming year. The APPwill address the following prevention areas: needs assessment, capacity building, planning, implementation, evaluation. The APPuses a consequence based logic model to outline SAP priorities, data that supports the identified priorities, intervening variables contributing factors in services, specific prevention strategies that will be used, targeted populations and proposed output/outcome measures.
The Substance Abuse Task Force (SATF) & Prevention Planning:As a part of, and in conjunction with the APP, CMHSAS-SJC also facilitates, manages and creates an annual SAP plan for our community-based Substance Abuse Task Force (SATF). The SATF is one of several community work groups that are overseen by the St. Joseph County Human Services Commission (HSC). CMHSAS-SJC,as the County’s, SWMBH’s and State’s designated SAP provider in St. Joseph County, has the responsibility to coordinate this community-based workgroup and report back to the HSC this workgroup’s activities on an annual basis. The SATF is a collection of willing key stakeholders in the County who have the common goal of reducing the incidence of and negative impact of substance abuse in our County.It is typically comprised of representatives of law enforcement, substance abuse and mental health treatment, area hospitals, public health, school districts, as well as other strategic sectors of the community. Like the APP, the SATF’s SAP action planis also based on data that indicates areas in need of prevention services, with specific outcomes to be accomplished, identified activities, and identified responsibilities for those community members involved.
Synar Inspections: CMHSAS-SJC, as the County’s, SWMBH’s and State’s designated SAP provider in St. JosephCounty, performs periodic formal Synar inspections as required by SAMHSA, State and Federal legislation. These tobacco sales compliance checks are conducted as directed by the regional SWMBH SAP coordinator utilizing all information, instructions, materials, and forms provided by such for the completion of the specific requirements of the Synar inspections. When the inspections are completed, all relevant data collected is reported back to the SWMBH regional SAP coordinator as directed.
Tobacco Retailer List: As required by the State and directed the SWMBH regional SAP coordinator, CMHSAS-SJC, as the designated SAP provider in St. JosephCounty, will review and update the list of tobacco retailers in St. JosephCounty. The updated list is sent back to the regional SAP coordinator to be included in the regional/State report on tobacco retailers in the State. In turn, this list is then used by the State to randomly select tobacco retailers for Synar inspections.
Youth Access to Tobacco Activity (YATA): Also as required by SWMBH and the State, CMHSAS-SJC, as the designated SAP provider in St. JosephCounty, provides information and data on items and activities related to Youth Access to Tobacco Prevention. This data is collected and submitted to the SWMBH regional SAP coordinator as directed and required for its inclusion in the mandated Annual Regional Youth Access to Tobacco Activity Report.
Domains of Substance Abuse Prevention Services
Universal Services: programs and activities that by their very nature and scope focus on broader and non-specified community groups/categories such as school, neighborhood and community, aimed at preventing or delaying the use of alcohol, tobacco and/or other drugs.
Selective Services: programs and activities that have a narrower scope and focus targeting subsets of community or population groups, which prevention research or other public health studies have identified as having higher risk and a greater likelihood to engage in substance abuse behaviors (i.e., children/families of persons with substance use disorders, persons experiencing repeated school failure, violent/delinquent behavior, economic disadvantages, persons in recovery, etc).
Indicated Services: programs and activities targeting individuals who are suspected or known to be using/experimenting with substances and/or are engaged in high-risk behaviors which significantly increase the likelihood of them becoming regular or chronic substance users.
Substance Abuse Prevention Strategies
Prevention methods or strategies fall into several different categories. There are three primary or core prevention strategies: community based process, education, and environmental initiatives. The three other strategies are rarely used independently and are usually allied with one or more of the core strategies.
Community-Based Process aims to enhance the ability of the community to more effectively provide prevention and treatment services for substance abuse by involving multiple community sectors. Activities include organizing, planning, implementing, interagency collaboration, coalition building, and networking.
Education involves two-way communication and is distinguished from the information dissemination strategy by the interaction between the educator and the participants. These prevention activities are aimed at effecting critical life situations, decision-making, improving social skills, refusal skills, critical analysis and systematic judgment abilities.
Environmental Initiatives include written or unwritten activities designed to change community standards, codes, and attitudes to positively influence the incidence and prevalence of substance abuse in the general population. This strategy is divided into two subcategories to permit distinction between activities that center on legal and regulatory institutions and those that relate to service initiatives.
Alternatives are used for the participation of the target populations in activities that exclude substance use. Activities that are designed to provide healthy, positive, pro-social diversions for young people to steer them from alcohol and other drugs; they can complement other strategies by occupying young people’s time during the non-school hours.
Information Dissemination is an attempt to communicate, inform, persuade or motivate behavior changes in a relatively well-defined and large audience. This is done by one-way communication from the source to the audience, with limited contact between the two.
Problem Identification & Referral is designed to identify those who have used tobacco and/or alcohol prior to being of legal age to do so and those first or early users of illicit/illegal drugs.
Risk Factors & Protective Factors
SAP services seek to identify and implement planned response to risk and protective factors in our County. Risk factors and protective factors exist in all domains of life: personal/individual, family, social/peer, school/work, community, society/ environmental. Risk factors are conditions that increase the chances and the likelihood that a person will experience substance use and related problems. Conversely, protective factors are those that buffer a person or reduce the chances of developing substance use and related problems. Identification of both factors is critical for the effectiveness of SAP services.
Indentified High Risk Groups
There are several identified high risk groups that are priority populations for receiving SAP services. They are:
- Children of substance abusers
- Pregnant women/teens
- Youth experiencing repeated school failure, chronic truancy or are school drop-outs; this may include those in alternative education settings
- Those who exhibit violent or delinquent behavior
- Youth involved in the Juvenile Justice system
- Persons experiencing mental health symptoms and/or are suicidal
- Persons experiencing chronic pain
- Victims of physical, sexual and/or psychological abuse
- Individuals who are homeless/runaways
- Persons who are economically disadvantaged
- Youth who are beginning to experiment with or are occasional users
- Children with prenatal exposure to alcohol, tobacco or other drugs.
- Additional high risk groups recognized regionally:
- Groups and neighborhoods affected disproportionately by violence and delinquency issues
- Youth in transition ages and school grades
- Youth in the foster care system
- Children of families affected by significant dynamics of dysfunctions
- Persons suffering from persistent discrimination and exclusion
- Victims of bullying or other types of social persecution.
CREDENTIALING & MONITORING
Substance Abuse Prevention Credentialing
CMHSAS-SJC has and will maintain a license through the State of Michigan to provide SAP services. (In addition, SWMBH would prefer that CMHSAS-SJC have and maintain SAP accreditation from a nationally recognized accrediting body, such as CARF, JCAHO and/or COA. CMHSAS-SJC is currently accredited by CARF to provide SAP services/programming.)
All CMHSAS-SJC SAPproviders, staff members/employees that do SAP programming and services, will have a current and valid SAP certification issued by MCBAP. This includes a CPS, CPC, CHES, equivalent or professional development plan thereof.
SAP services and/or programming may be provided by a non-CMHSAS-SJC staff or volunteer when documented and directly supervisedby a responsible certified SAP staff member.
Monitoring of Substance Abuse Prevention Activities
As a member of SWMBH, CMHSAS-SJC will report its SAP activities to SWMBH to facilitate regional and State accountability and coordination of SAPservices. The regional SAP coordinator at SWMBH will provide ongoing guidance, reviews and monitoring of SAP services provided by CMHSAS-SJC. This coordinated and collaborative monitoring arrangement will be done in several ways.
Annual Review of CMHSAS-SJC’s SAP services is conducted by the regional SAP coordinator at SWMBH as a part of the creation of the APP. Periodic monitoring and reviews may be conducted throughout the year.
Michigan Prevention Data System (MPDS) is a State SAP data base used to report and track SAP services in the State. As the SWMBH/State designated SAP provider in St. JosephCounty, CMHSAS-SJC will report its SAP activities in the MPDS on a monthly basis. MPDS reporting requires the submission of a report on each SAP activity that includes the date, duration, type, strategy employed, EBP used, and participants involved or targeted. MPDS data will be reviewed by the regional SAP coordinator at SWMBH to monitor such activities and CMHSAS-SJC’s adherence to our APP.
Fidelity Review Reports are also completedand submitted to the regional SAP coordinator at SWMBH on every EBP curriculum-based SAP program cited in the APP. This helps to ensure that all such EBP SAP programming are being conducted in a manner consistent with the research upon which it is based, across our region and the State. Any adaptation or change of any EBP program needs to be documented and reviewed the regional SAP coordinator at SWMBH.
REFERENCES
Southwest Michigan Behavioral Health Policy - 11.10 (Substance Abuse Prevention Services)
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