This case study on the San Antonio, Texas police department’s Mental Health Detail (MHD) was produced by the National League of Cities as part of their series on local efforts to address the interrelated challenges of mental illness, substance use, and homelessness. The case study describes the MHD program and the lessons learned by MHD leadership during program implementation including advice for individuals interested in replicating the program in their communities. Funding Source: Arnold Ventures & National League of Cities

This third report in a series from the National League of Cities focuses on how local leadership addresses the interrelated challenges of mental illness, substance use and homelessness. This report describes 5 challenges leaders face in creating innovative emergency response or crisis stabilization programs: obtaining sustainable, flexible funding; addressing social determinants of health; overcoming stigma; conducting primary data collection and analysis; and developing facilities and workforce. The report provides examples of ho leaders in local communities have addressed these challenges and concludes with recommendations on how local efforts in these areas could be enhanced and improved. Funding Source: Arnold Ventures & National League of Cities

This second report in a series from the National League of Cities focuses on how local leadership addresses the interrelated challenges of mental illness, substance use and homelessness. This report provides detailed information about 3 innovative programs: the Huntington, West Virginia Quick Response Team which provides crisis stabilization and referral to treatment services for individuals who have experienced an overdose; the San Antonio, Texas police department’s Mental Health Detail which has specially trained officers respond to calls from people in mental health crisis; and the Wichita, Kansas police department’s Homeless Outreach Team which responds to calls involving individuals experiencing homelessness. Funding Source: Arnold Ventures & National League of Cities

This 2018 report from the Substance Abuse and Mental Health Services Administration provides guidance for collecting data to evaluate Crisis Intervention Team (CIT) programs for intervening in mental health and substance use disorder crises. One of the core elements of the CIT model is to use evaluation and research to sustain CIT programs. This guidance is specifically to assist CIT programs in developing their data collection and evaluation plans. Funding Source: Substance Abuse and Mental Health Services Administration

This first report in a series from the National League of Cities focuses on how local leadership addresses the interrelated challenges of mental illness, substance use and homelessness. This report focuses on communities that have implemented innovative programs to divert individuals in crisis to treatment and services rather than law enforcement sanctions. The report describes communities who have implemented partnerships between first responders and behavioral health service providers, police and fire department referral to treatment programs, and regional dedicated emergency psychiatric facilities. Funding Source: Arnold Ventures & National League of Cities

Crisis Intervention Team (CIT) programs are collaborations between law enforcement, mental health professionals, and mental health advocates that work to improve community responses to mental health crises. This implementation guide from CIT International outlines the steps community leaders can take to design, implement and sustain CIT programs in their communities. Funding Source: Various grants, donations and conference fees Authors: Usher, L., Watson, A.C., Bruno, R., Andriukaitis, S., Kamin, D., Speed, C., & Taylor, S.

An overview of the core elements of the Crisis Intervention Team (CIT) model, a collaboration of law enforcement, mental health care providers, and mental health care advocates that works to improve crisis intervention services during mental health crises. Originated in Memphis, Tennessee, this document defines and describes the core elements of the CIT model which has been adopted in communities across the country and internationally. Funding Source: CIT International

This model legislation is designed to help state legislatures create programs in their states that allow law enforcement officers to divert some individuals with substance use disorders or mental health conditions away from arrest and prosecution to treatment and other supportive services. The law is intended to help states create collaborative programs between law enforcement, treatment providers, and community organizations that allow these individuals to access treatment and services and avoid justice involvement. Funding Source: Office of National Drug Control Policy

This 3 minute video features the story of an individual who was assisted by Seattle’s Law Enforcement Assisted Diversion (LEAD) program. It includes interviews with case managers, law enforcement officers, and recipients of service and explains how the program improves outcomes for individuals in the community. Funding Source: Arnold Ventures

A 2 and a half minute video about how the Cabell-County-Huntington, West Virginia Quick Response Team works to engage community members with substance use disorders in treatment. Funding Source:  West Virginia Department of Health and Human Resources

Presentation slides that provide an overview of strategies law enforcement and first responders can adopt in collaboration with community organizations to create pre-arrest diversion options for individuals with substance use disorder or mental health conditions. Prepared by Jac Charlier of the Police Treatment Community Collaborative and Treatment Alternatives for a Safer Community, the slides briefly describe multiple strategies adopted in communities across the country to reduce arrests, protect public safety, and prioritize treatment for individuals in need. Funding Source: Center for Health & Justice at Treatment Alternatives for a Safer Community

A 12 minute video that explains the Law Enforcement Assisted Diversion (LEAD) program through a conversation with a client, police officer and case management. The LEAD program seeks to provide a pre-diversion program that treats addiction as a public health issue rather than seeking arrest and court involvement.Funding Source: Law Enforcement Assisted Diversion

This 3 minute video features the story of an individual who was assisted by Seattle’s Law Enforcement Assisted Diversion (LEAD) program. It includes interviews with case managers, law enforcement officers, and recipients of service and explains how the program improves outcomes for individuals in the community. Funding Source: Arnold Ventures

An overview of the Ocean County, New Jersey Prosecutor’s Office efforts to work with law enforcement to provide access to treatment and recovery for community members with substance use disorders (SUD). The Blue Heroin Addiction Recovery & Treatment (HART) program began with enhanced naloxone distribution to first responders in 2013, expanded to providing recovery support coaches to patients seen in the emergency department for an opioid overdose, and led to creating treatment intake stations at 6 Ocean County police stations. Part of the Addiction Policy Forum’s Spotlight series which highlights innovative programs to address the opioid crisis. Funding source: Various grants and donations This resource was produced by an individual/organization receiving funding from sources that have a conflict of interest such as a pharmaceutical company, political action committee, or other industry-related sources. Multiple studies indicate that research performed by individuals with relationships to industry and research funded by industry sources are more likely to favor the sponsor’s products. Industry funding of charities and non-profit organizations has also been linked to groups supporting industry-favorable positions. For more information, please visit the CLOUD 101 page.

This document serves as a template for conducting informed consent (also known as PARQs – procedures, alternatives, risks and questions) for patients beginning medication assisted treatment with buprenorphine or naltrexone. This template is used by Oregon Health & Science University’s Improving Addiction Care Team (IMPACT). IMPACT provides addiction medicine consultations to patients treated in the hospital who have a diagnosis of substance use disorder. Funding Source: Oregon Health & Science University

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This document serves as a template for medical notes of the addiction consult provided by Oregon Health & Science University’s Improving Addiction Care Team (IMPACT). IMPACT provides addiction medicine consultations to patients treated in the hospital who have a diagnosis of substance use disorder. Funding Source: Oregon Health & Science University

This resource serves as a guide to speaking with patients who use drugs about harm reduction strategies such as safe injection tips, HIV prevention and prophylaxis, and naloxone to treat opioid overdose. It is one of the protocols and tools developed for Oregon Health & Science University’s Improving Addiction Care Team (IMPACT) program which provides addiction medicine consultations to patients treated in the hospital who have a diagnosis of substance use disorder. Funding Source: Oregon Health & Science University

This resource serves as Project IMPACT’s guide to conducting a patient care conference to consider hospital discharge planning for patients receiving intravenous antibiotic therapy. This guide lists the steps for convening and conducting the conference and includes a meeting guide and note template. Funding Source: Oregon Health & Science University

This template is of a social work assessment for safe discharge of patients using a PICC line to receive medications used by Oregon Health & Science University’s Improving Addiction Care Team (IMPACT). IMPACT provides addiction medicine consultations to patients treated in the hospital who have a diagnosis of substance use disorder. Funding Source: Oregon Health & Science University

This resource captures Oregon Health & Science University’s practice recommendations for the management of pain in patients on buprenorphine undergoing surgery and pregnant women during labor, delivery, and the post-partum period. The guidelines were developed through an evidence review of the harms and benefits of continuing buprenorphine treatment during these clinical episodes. and the clinical expertise and consensus of the guideline committee. The committee issued a strong recommendation for continuing buprenorphine but noted the very low strength of evidence available to guide decisions. This policy was included as one of the protocols and tools for Oregon Health & Science University’s Improving Addiction Care Team (IMPACT) program which provides addiction medicine consultations to patients treated in the hospital who have a diagnosis of substance use disorder. Funding Source: Oregon Health & Science University

This document provides a template for substance use disorder assessment as used by Oregon Health & Science University’s Improving Addiction Care Team (IMPACT). IMPACT provides addiction medicine consultations to patients treated in the hospital who have a diagnosis of substance use disorder. Funding Source: Oregon Health & Science University

This resource is Oregon Health & Science University’s pharmacy and therapeutics policy on the use of medications (methadone, buprenorphine, and naltrexone) for opioid withdrawal management or opioid maintenance therapy in patients with opioid use disorder who are hospitalized or seen in the emergency department. The document describes the hospitals procedures for patients who present to the emergency department or labor and delivery for a missed medication dose, patients who are treated in the hospital who are on maintenance medication therapy, on patients seeking treatment of withdrawal or induction to maintenance therapy. This policy was included as one of the protocols and tools for Oregon Health & Science University’s Improving Addiction Care Team (IMPACT) program which provides addiction medicine consultations to patients treated in the hospital who have a diagnosis of substance use disorder. Funding Source: Oregon Health & Science University

This resource serves as a guide to managing opioid or alcohol withdrawal in hospitalized patients with substance use disorder. It is one of the protocols and tools developed for Oregon Health & Science University’s Improving Addiction Care Team (IMPACT) program, which provides addiction medicine consultations to patients treated in the hospital who have a diagnosis of substance use disorder. Funding Source: Oregon Health & Science University

This case study describes the Improving Addiction Care Team (IMPACT) model developed at Oregon Health & Science University to provide addiction medicine consultations during inpatient hospitalization and provide transitions to community based substance use disorder treatment upon discharge.

This 3 minute video describes Project IMPACT (Improving Addiction Care Team) operating at Oregon Health and Science University. The video includes program director Honora Englander, M.D., Melissa Weimer, D.O. and peer-recovery counselor O’Nesha Cochran. Funding Source: Oregon Health & Science University

This collection compiles research and implementation materials from the Improving Addiction Care Team (IMPACT) program from Oregon Health & Science University (OHSU). IMPACT is an interprofessional, hospital-based addictions team that provides addiction medicine consults to patients being treated at OHSU who have a substance use disorder (SUD). Hospitals treat many patients with complications from SUD such as endocarditis (inflammation of the heart lining), soft issue infections, and traumatic injuries, but most do not offer services or resources that address the underlying cause – the SUD itself. With IMPACT, inpatient medical and surgical providers and hospital social workers can refer patients with known or suspected SUD to receive services from the IMPACT team. Services include a comprehensive SUD assessment, a process to help the patient set patient-centered goals for their treatment, induction onto medication assisted treatment, direct connections to community based SUD treatment, and information about harm reduction strategies such as safe injection protocols, information about HIV prevention and prophylaxis, and education about naloxone for overdose referral. This collection includes a summary of the research on IMPACT that has been published in peer-reviewed journals and references to those articles, a brief video explaining the program, a summary of the program from…

A resource guide to help law-enforcement agencies create pre-arrest diversion programs for individuals with substance use disorder from the SAFE Project and the Police, Treatment, and Community Collaborative. The guide describes what pre-arrest diversion consists of, defines 2 types of pre-arrest diversion programs, and provides case studies of 5 programs: a self-referral pathway, an active outreach pathway, a naloxone plus pathway, an officer prevention pathway, and an officer intervention pathway. Funding source: Various grants and donations

Website for the Police Treatment and Community Collaborative (PTACC), an alliance of individuals working in law enforcement, behavioral health, community, advocacy, research and public policy whose mission is to enhance pre-arrest diversion pathways to treatment and social services. The goal is to reduce justice system involvement and the collateral consequences of arrests and convictions while enhancing public safety by providing access to substance use disorder and behavioral health treatment for individuals who need it. Funding Source: Various grants and conference fees