Substance Use Care and Treatment

CHDI is improving care for young people with co-occurring mental health and substance use needs through timely substance use screening and care that’s available in the same place they go for mental health support.

Improving Substance Use Care for Young People with Co-occurring Conditions

Youth substance use is a concern for many families, yet less than 40% of adolescents and only 16% of young adults who need substance use treatment receive it. CHDI is working to change this by helping behavioral health providers identify and address early substance use among patients with mental health disorders and, if needed, connect them to high-quality treatment. 

With the support of the federal and state funding, CHDI is leading three initiatives to expand the availability of evidence-based substance use screening, early intervention, and treatment for adolescents and young adults in community-based mental health settings across Connecticut. The initiatives include SBIRT PATHS, CT-TREE, and the Substance Use Disorder Project.

SBIRT PATHS

Screening, Brief Intervention, and Referral to Treatment Prevention and Access to Treatment Hubs and Services (SBIRT PATHS) is a five-year initiative developed and led by CHDI to expand access to timely and effective substance use care for youth with substance use and co-occurring disorders in five Connecticut counties. It is funded by a $5 million grant from the Substance Abuse and Mental Health Services Administration (SAMHSA) awarded to CHDI in September 2024. 

The primary goal of SBIRT PATHS is to provide integrated substance use, mental health, and trauma-informed services for youth ages 12-21 with low and moderate risk substance use. This initiative will:

• In partnership with community-based clinical providers in each region, establish "hubs" to provide integrated substance use and co-occurring disorder care to thousands of youth in the five Connecticut counties (Fairfield, New Haven, New London, Hartford, Windham) with the highest percentage of youth living below the poverty line
• Expand three evidence-based practices (EBPs) for youth utilizing a learning community framework: SBIRT, Motivational Enhancement Therapy / Cognitive Behavioral Therapy (MET/CBT), and a Wraparound approach for coordinating services.
• Build community-based, localized partnerships to ensure youth are identified for screening and stay connected to services and care planning throughout treatment
• Begin to develop a Connecticut community-based model of co-occurring care for youth

Behavioral health partners that will establish the regional service "hubs" include The Child & Family Agency (serving New London County), Child and Family Guidance Center (Fairfield County), Clifford Beers Community Care Center (New Haven County), and Community Health Resources (Hartford and Windham Counties).

Organizational partners providing guidance and support include the Connecticut Department of Children and Families (DCF), Connecticut Department of Mental Health and Addiction Services (DMHAS), UConn School of Social Work (the project evaluator), the Center for Behavioral Health Integration, FAVOR, and Connecticut Community for Addiction Recovery (CCAR).

Learn more about SBIRT PATHS in our recent news story.

Connecticut Treatment Expansion and Enhancement (CT-TREE) initiative 

CT-TREE is a partnership between CHDI and United Community and Family Services (UCFS) to improve the treatment of substance use disorders for transitional-aged youth (ages 16-25) in eastern Connecticut. The CT-TREE initiative will expand two well-established, evidence-based substance use disorder treatment models at UCFS Federally Qualified Health Centers located in Norwich, New London, Griswold, Plainfield, and Colchester. The models include:

• Screening, Brief Intervention, and Referral to Treatment (SBIRT):  SBIRT, including the Adolescent adaptation called A-SBIRT, is a comprehensive EBP approach that efficiently trains direct service staff to detect substance use with validated screens, use a brief intervention with motivational interviewing (MI) to engage young people in behavior change and refer them to treatment.

• Multidimensional Family Therapy for Transitional Aged Youth (MDFT-TAY): MDFT-TAY addresses substance use problems in four to six months with TAY (aged 16 through 25), caregivers, the family, and the community. Services are provided in a hybrid format, which includes telehealth, in-home, and clinic-based sessions by a a behavioral health clinician, clinical supervisor, and a recovery coach.

CT-TREE will establish an Advisory Committee that includes stakeholders from the Connecticut Department of Children and Families and Department of Mental Health and Addiction Services, community providers, and transitional-aged youth living with substance use disorders. The initiative is funded by a five-year $2.7 million grant from the Substance Abuse and Mental Health Services Administration (SAMHSA) awarded to CHDI in June 2023. View the News Release announcing CT-TREE

Substance Use Disorder Project (A-SBIRT)

CHDI works with the State of Connecticut to improve early substance use identification initiation and treatment engagement for youth to reduce the use of higher levels of care through improved access to services. Outpatient Psychiatric Clinics for Children (OPCC) providers across the state who partner in this project will offer the following evidence-based substance use support to youth using substances through a team of clinicians and wraparound care coordinators:

• Adolescent Screening, Brief Intervention, and Referral to Treatment, (A-SBIRT): A-SBIRT detects substance use through validated screens. Once screened, a provider can use brief intervention or treatment with motivational interviewing (MI) to engage the youth in behavior change. This can be done briefly or integrated within outpatient treatment for youth with mild or moderate substance use disorders. Providers can refer youth with severe substance use concerns and families to more intensive care.

• Wraparound Care Coordination: Wraparound care coordination helps families identify and meet their needs and build supports. Services are uniquely tailored for families and youth with SUD concerns.

OPCC provider initiative partners include:

• Child and Family Agency of Southeastern Connecticut (CFA)
• Clifford Beers Community Care Center
• Community Health Resources (CHR)
• Community Mental Health Affiliates (CMHA)
• The Child and Family Guidance Center, and
• United Community and Family Services (UCFS)
• Wellmore Behavioral Health

CHDI provides quality improvement, data collection, and reporting of youth substance use disorders receiving Care Coordination and A-SBIRT services and will facilitate statewide substance use disorder reimbursement education.

This project is part of a larger statewide effort to expand the continuum of substance use disorder services across the lifespan that is funded by the State via a federal 1115(a) Demonstration Waiver from January 1, 2023 through June 30, 2025.

A-SBIRT can also be useful in pediatric primary care settings. To learn more, watch this January 2024 recording of a virtual training on A-SBIRT for Pediatric Primary Care presented by Senior Associate Christine Hauser, LCSW, LADC for Access Mental Health for Youth CT (scroll down to "Substance Use Disorders").

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