Whole Person Health: Integrating care for mental health and substance use disorders

Mental health needs and substance use disorders are often interconnected, with each potentially influencing the onset, severity, or recovery process of the other. Statistics show that when an individual experiences a mental health condition and challenges related to drug and/or alcohol use —referred to as a co-occurring disorder—they’re at higher risk for worse health outcomes, homelessness and incarceration.

This is a substantial issue across the U.S. According to the Substance Abuse and Mental Health Services Administration (SAMHSA)’s National Survey on Drug Use and Health in 2023, approximately 20.4 million adults in the United States have a co-occurring mental illness and substance use disorder, and only about one in five of those folks received treatment for both conditions.

Like most health issues, when a condition escalates, it requires more intensive—and more expensive—treatment. Prevention, and addressing conditions holistically, is the key to better outcomes.

In our communities, we were seeing people who suffered from both a mental health crisis and the effects of their substance use, such as withdrawal symptoms. These individuals came to us seeking help, and our team was driven to make sure we could treat all of their needs.

That’s why Compass Health has expanded our protocols and collaboration with community partners to better treat the whole person, and to put them on the best path for stabilization and recovery.

Early last year, our clinical team set out to develop an alcohol and opiate withdrawal protocol that would enable the team at our Mukilteo Evaluation & Treatment (E&T) facility to assess and support adults suffering from mental health and substance use challenges. The E&T is a 16-bed inpatient program for adults experiencing acute symptoms of a behavioral health disorder, with the goal of helping individuals stabilize their psychiatric symptoms so that they may safely return to the community.

The idea was that, if we could implement this protocol now, we could eventually expand it to Phase II of our Broadway Campus Redevelopment, which will open in July 2025 and house another 16-bed E&T. We’re on track to do just that, meaning we can better serve the needs of our neighbors throughout Snohomish County and beyond.

Fortunately, as a behavioral healthcare agency that spans five counties across Northwest Washington, we already had many of the necessary tools to get this protocol started, and our team was willing to realign and put the work in to make this a reality.

While the therapists, nurses and other providers already at our E&T evaluate the mental health needs of a new client, we began utilizing telehealth to connect individuals who came to us with a co-occurring disorder to a substance use disorder professional (SUDP) on our San Juan team. This new process has enabled us to intake clients who present with mental health needs and a substance use disorder. Together, the team identifies the full spectrum of needs, so that we can create a robust, holistic treatment plan.

With a SUDP in place, we took the next steps of building out our alcohol and opiate withdrawal protocol, including:

  • Building upon our partnership with Genoa Healthcare to fulfill prescriptions at our on-site pharmacy, including coordinating orders of suboxone for clients struggling with opiate use disorder.
  • Working with our talented team of clinicians, nurses, providers and support staff to ensure they feel confident in carrying out treatment plans for individuals with positive drug screenings, beginning by guiding them through withdrawal —a process that can be extremely challenging for both the client and care providers.
  • Enhancing the transition process to connect clients with the support they need following their stay at the E&T—such as outpatient counseling at Compass Health—to ensure that patients can seamlessly move through the steps of recovery.
  • Developing best practices for everyone to follow, which we could tweak or adjust as needed, and plan to implement at Phase II of our Broadway Campus Redevelopment once it’s complete.

We officially rolled out the protocol at our Mukilteo E&T in February 2024 and to date, we’ve increased the number of patients we can take in and treat. In 2023, the average daily bed utilization census at the E&T was 11.8, but since implementing the protocol, the average daily bed utilization census has increased to 14.5, meaning we’ve been able to serve 23 percent more clients with this process.

In addition to allowing us to better serve our community today, the work to develop this alcohol and opiate withdrawal protocol supports our efforts to become Certified Community Behavioral Health Clinic (CCBHC) ready. Washington state is currently in the process of adopting the CCBHC model statewide, which will require providers like us to deliver specific services to meet the complex needs of our communities. The steps we’ve taken to develop and implement this protocol represent a significant milestone on our journey toward operating CCBHCs in the near future.

The next step of this journey is to implement this protocol in Phase II of the Broadway Campus Redevelopment project. Once the 72,000 sq. foot facility is complete, it will host a brand-new E&T as well as plenty of innovative spaces designed to welcome people and meet the holistic needs of our community, including gathering spaces for AA meetings, offices for crisis prevention, outreach and engagement teams and an on-site pharmacy. Once Phase II is complete, it will be majorly impactful in serving our community’s needs, connecting people facing these challenges to the care they need to start their journey to recovery.

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