Integrated Health, Behavioral Health, and Substance Use

Active grants

The Integrated Health, Behavioral Health, and Substance Use research area examines the health and behavioral health risk and protective factors for under-served populations. Topic areas include substance abuse, trauma, gambling, suicide, LGBTQ+, mental health, and infant mental health.


Collaborative Research: D-ISN: Assessing the Relationship between Drug Market Disruptions and Overdoses

Principal Investigator: Brad Ray

Grant funder: RTI International for the National Science Foundation

The overall goal of this project is to develop national and local data sources that allow us to model and mitigate the unintended impact of law enforcement efforts to disrupt the illicit drug supply network. Our analysis will look both at county and neighborhood level effects of the illicit supply network and distinguish across multiple illicit substances (e.g., fentanyl, heroin, methamphetamine, cocaine, benzodiazepines, prescription medications, and cannabis). We will study the effect of network disruptions on the transition to more potent substances and subsequent changes in rates of drug overdoses.


Comprehensive Opioid Abuse Program (COAP-ISDH): Toxicology

Principal Investigator: Brad Ray

Grant funder: Indiana State Department of Health

The Indiana State Department of Health has received funding from the Comprehensive Opioid Abuse Program (COAP) from the U.S.Department of Justice (DOJ) for Category 6: Public Safety, Behavioral Health, and Public Health Information-Sharing Partnerships (Grant Number: 2018-AR-BX-K095). Objectives of this project include: Rolling out the current funding of toxicology testing to all 92 counties in the state, expanding on the current efforts to test all suspected overdoses in emergency departments whether fatal or non-fatal, linking data between INSPECT, Coroner Case Management System, and the previously mentioned toxicology test results. The ISDH will produce aggregate state and county quarterly reports on toxicology for suspected overdoses involving any-drug, any-opioid, and/or heroin occurring from within two months of the overdose related death. The ISDH will investigate using existing surveillance data systems for the purposes of tracking fatal overdoses. The ISDH will link toxicology results with existing demographic information regarding the deceased and disperse aggregated data to the Opioid Data Work Group. The research partner collaborating with ISDH will be Brad Ray, Director of the Center for Behavioral Health and Justice (CBHJ) at Wayne State University.


Evaluation of grant titled "Overdose Fatality Review Teams (OFRTs)"

Principal Investigator: Brad Ray

Grant funder: Indiana State Department of Health

Overdose Fatality Review Teams (OFRTs) have been established in various counties across the country as a means of addressing overdose fatality on a community level. A peer-to-peer initiative through the BJA and CDC has allowed for the development of OFRT "hubs" to serve as a resource for other communities implementing OFRTs. The Center for Behavioral Health and Justice (CBHJ) will work with OFRTs through these hubs, and look for additional cites beyond them, to conduct a process evaluation aimed at exploring different OFRT implementation models in an effort to identify best-practices. 


GRPA Data Collection for the Indiana Emergency Grant to Address Mental and Substance Use Disorders During COVID-19

Principal Investigator: Brad Ray

Co-Investigator: Erin Comartin

Grant funder: Indiana Division of Mental Health and Addiction

Dr. Brad Ray and researchers from the Center for Behavioral Health and Justice (CBHJ) at Wayne State University will partner with the Indiana Division of Mental Health and Addiction (DMHA) to oversee the collection of GRPA data for the SAMHSA COVID-19 emergency response grant. The Government Performance and Results Act (GPRA) mandates the collection of specific client-level data on various health-related indicators, including employment status, HIV/Hepatitis C status, substance use disorder, and mental health and physical health history, among others. The CBHJ research team has utilized the GPRA questionnaire in numerous studies and has extensive experience collecting and analyzing GPRA data. We have previously partnered with Indiana DMHA to collect GRPA data on clients receiving medications for opioid use disorder (MOUD) as part of prior SAMHSA funding, including the State Opioid Response.


INSPECT Database Analysis

Principal Investigator: Brad Ray

Grant funder: Indiana State Department of Health

A quantitative analysis of the INSPECT database to obtain the performance metrics (changes in the volume of opioid dispensation in Indiana; the number of patients receiving and providers prescribing chronic opioid therapy; the number of patients who doctor- or pharmacy-shop (acquiring medications from multiple sources); and the number of patients who receive and providers who prescribe both opioids and other controlled substances simultaneously. Delivered as policy brief to ISDH. A quantitative examination of the relationship between medication assisted therapies (MAT) and fatal and nonfatal overdose using record linked MPH data. We will assess what proportion of individuals were dispensed an MAT (via INSPECT) following the non-fatal event (via EMS and ED data) and the time to dispensation of the MAT. We will report out descriptive statistics by county and over time on the proportion of non-fatal overdoses who dispensed an MAT as well as those who prescribed an opioid analgesic. Delivered as policy brief to ISDH.


Recovery Works Contract Amendment 1

Principal Investigator: Brad Ray

Grant funder: Indiana Family and Social Services Administration

The purpose of this funding is for the continued evaluation of Recovery Works, which will focus on linking data from the Indiana Division of Mental Health and Addiction's (DMHA) Recovery Works program to the Indiana Management Performance Hub's (MPH) Drug Data Warehouse. The MPH data elements include information from emergency medical services (EMS), the emergency department (ED), vital records, Indiana State Police (ISP), and the Indiana Department of Corrections (DOC). Data on Recovery Works includes information from DARMHA (Data Assessment Registry Mental Health and Addiction), which contains NOMS (National Outcomes Measures) from baseline engagement as well as follow-up periods, and WITS (Web Infrastructure for Treatment Services) information on vouchers. Moreover, DMHA can provide agency level indicators to determine from whom Recovery Works clients received treatment or services in the community. This data should allow us to examine several additional outcomes among Recovery Works clients such as (1) EMS utilization, (2) ED utilization, (3) arrest by ISP, (4) incarceration in DOC, and (5) mortality.


Social Determinants of Health in Detroit Public Schools

Principal Investigator: Rebeccah Sokol

Grant funder: Wayne State University Research Grant Program

Detroit, Michigan is a city whose residents have historically experienced high levels of social determinants of health. Detroit has a poverty rate nearly three times higher than the national average—roughly 35%, and the child poverty rate is even higher, at more than 50%.9 Yet, Detroit is also a rich urban environment with unique resources established to help address these social needs. The present research aims to address the above major gaps in SDH screening to inform future SDH screening practice in Detroit, Michigan. Through implementing a quasi-Delphi method survey with Detroit Public Schools Community District middle school students, and holding focus groups with middle school staff, leaders, and parents from Detroit Public Schools Community District, this study seeks to: Aim 1: Identify the SDHs that are a high priority to adolescents within Detroit Public Schools. Aim 2: Assess the feasibility of school-based SDH screening to identify and address the SDHs that are a high priority to students within Detroit Public Schools, including a) the acceptability, potential barriers, and unintended consequences of school-based SDH screening, and b) practical mechanisms for overcoming such barriers and avoiding negative consequences This is the first study to critically consider the development process of an SDH screener for the youth of Detroit, and it is the first study to evaluate school-based SDH screening feasibility. This research will develop Dr. Sokol's expertise in social factor screening as a public health intervention and prepare her for research independence and the submission of a K01 and eventual R01 application to the Eunice Kennedy Shriver National Institute of Child Health and Human Development.


State Opioid Response II - Evaluation and Data Collection

Principal Investigators: Elizabeth Agius and Stella Resko

Grant funder: Michigan Department of Health and Human Services

The Michigan Strategic Response to Opioid Crisis Supplemental is funded by SAMHSA to allow the state to increase the number of prevention and treatment opportunities in an effort to stem the tide of rising opioid related hospitalizations and deaths. The State of Michigan Dept. of Health and Human Services, Office of Recovery Oriented Systems of Care will contract with Wayne State University School of Social Work (WSU) to conduct a performance assessment of the evidenced based prevention and treatment strategies selected, as well as the overall project implementation. Elizabeth Agius, the Manager of Community Partnerships and Dr. Stella Resko will serve as Co-PIs of the performance assessment. Our goals will be: 1) collect data in line with GPRA requirements; 2) analyze data to assess performance and outcome measures for GPRA requirements; 3) provide providers and OROSC with regular reporting and feedback on GPRA data; 4) assess performance and outcomes on evidence-based practices used; and 5) complete reporting requirements as outlined in the grant. The products will include: 1) A final evaluation plan created within a month of the grant start date. 2) Quarterly reporting to the E-grams system on progress toward goals; 3) Annual written reports to the State; 4) Assistance as requested to complete any additional reporting required. The evaluation will include process and outcome measurement across the range of activities and partners involved in the grant.


Trajectories of Tobacco Use, Stress, and Health among U.S. Transgender Youth and Adults

Principal Investigator: Luisa Kcomt

Grant funder: University of Michigan

Studies have shown that the prevalence of nicotine/tobacco use are higher among transgender populations (individuals whose gender identity differs from their assigned sex at birth) relative to cisgender populations. The majority of work on nicotine/tobacco use among transgender populations comes from cross-sectional studies. Despite the growing body of research on transgender health, there remains limited understanding about gender-fluid individuals (i.e., individuals who experience changes in gender identity over time) because of conventional binary conceptualizations of gender and the inability of cross-sectional studies to assess gender fluidity. Research is needed to understand the trajectories of nicotine/tobacco product use, assess tobacco-related health consequences, and detect modifiable factors over time that may mitigate risk among transgender individuals. Using nationally representative longitudinal data from the Population Assessment of Tobacco and Health (PATH, Waves 1, 2, 3, and 4; n=45,971), this project will explore differences between gender-fluid versus gender-stable individuals in their nicotine/tobacco product use, examine trajectories of nicotine/tobacco product use as a function of gender stability/fluidity over time, and assess multi-level factors hypothesized to influence trajectories of nicotine/tobacco product use among gender-fluid and gender-stable participants over time. Findings from this study will enhance understanding of modifiable factors influencing nicotine/tobacco product use and trajectories among gender-fluid people—knowledge that is essential to the development of prevention, intervention, and tobacco control policy efforts for this underrepresented population. It will provide the first national prevalence estimates of tobacco use among gender-fluid individuals.


Wayne State University Opioid Inter-Professional Clinical Collaborative (WOICC) Program

Principal Investigators: Umeika Stephens, College of Nursing and Suzanne Brown

Grant funder: U.S. Health Resources & Services Administration (HRSA)

This project is being conducted by the Wayne State University (WSU) College of Nursing (CON), in partnership with the School of Social Work (SSW), the Department of Psychology (Psych), and the School of Medicine Department of Psychiatry in Detroit, Michigan for the Opioid Workforce Expansion Program Professionals. The purpose is to develop and increase the number of behavioral health professionals trained to address the current national opioid and substance use crisis by the advancement of clinical practice for nursing, social work, psychology, and psychiatry students through the provision of culturally competent, enhanced inter-professional education and core competencies, with emphasis on children, adolescents, transitional aged-youth, adults, and their families, at risk for developing or who have developed a recognized opioid or substance abuse disorder in high service need areas. The purpose will be achieved through the following goals: 1) To foster advanced psychiatric mental health nursing, social work, psychology, and psychiatric residents' clinical education that focuses on evidenced based prevention and treatment modalities in recovery oriented service programs for children, adolescents, transitional aged-youth, adults, and their families, who are at risk for developing or who have developed a recognized opioid or substance abuse disorder across a diverse spectrum of interdisciplinary integrated care healthcare settings; 2) To develop and implement planned inter-professional education (IPE) that includes interdisciplinary didactic seminars and content training modules to enhance knowledge and foster expansion of critical clinical skills for students, faculty, and clinical preceptors from the College of Nursing (CON-PMHNP), School of Social (SSW-MSW), Department of Psychology (DOP-MA), Department of Psychiatry (SOM-MD) and community partners that focus on the needs of patients who have developed a recognized opioid or substance use disorder with an emphasis on treatment for harmful behaviors (mental illness, suicide, trauma) 3) To develop and implement inter-professional clinical (field) learning experiences for master's level Psychiatric Mental Health Nurse Practitioner students (PMHNP), masters-level psychology students, psychiatric residents (MD), and masters-level Social Work students with established community partners that provide evidence based integrated substance abuse treatment services and can support the clinical (field) training of 2 or more disciplines in medically underserved high need areas in Wayne County, Michigan; and 4) To conduct formative and summative program evaluation that includes the assessment of program initiation, quality of inter-professional learning, field experiences with a focus on individuals and families with substance use concerns, health concerns, as well as, effective dissemination of program information and outcomes, and adherence of graduates chosen work focus upon completion of the program.


Wayne State University Interdisciplinary Trauma-Informed Collaboration (ITIC) to Address Behavioral Health Disorders among Children, Adolescents and Transitional-Age Youth in Integrated Healthcare Settings

Principal Investigator: Suzanne Brown

Collaborating: Anwar Najor-Durack

Grant funder: U.S. Health Resources & Services Administration (HRSA)

This application is a competitive continuation submitted by the Wayne State University (WSU) School of Social Work (SSW), in collaboration with the College of Nursing (CON) and Department of Psychology (DP), in Detroit, Michigan for the Professional Behavioral Health Workforce Education and Training Program. The purpose of this project is to develop and enhance the behavioral health workforce, and to advance nursing, social work, and psychology education, and clinical practice through the provision of culturally competent, enhanced interprofessional education (IPE), with emphasis on children, adolescents, and transitional age youth at risk for developing or who have developed a recognized behavioral health disorder, in an integrated primary care environment. The goals of this project are: 1) To foster advanced psychiatric mental health nursing and social work education focused on children, adolescents, and transitional age youth from medically underserved communities (MUC), at risk for developing or who have developed a behavioral health disorder, within integrated healthcare settings; 2) To develop and implement interprofessional education (IPE) including didactic courses and training modules with students from the School of Social Work (MSW), College of Nursing (PMHNP), and Department of Psychology (PhD), at Wayne State University; 3) To develop and implement interprofessional clinical (field) learning experiences for PMHNP, MSW, and PhD students in integrated primary care settings, that focus on children, adolescents, and transitional age youth, at risk for developing or who have developed a recognized behavioral health disorder. Our emphasis will be on Trauma-Informed assessment and clinical intervention and treatment for at-risk behaviors, including ACEs, substance abuse, suicidality, interpersonal violence, and maladaptive use of social media, in MUCs in Detroit, and 4) To conduct formative and summative program evaluation to assess program initiation, quality of interprofessional learning, field experiences, dissemination of project outcomes, and adherence of graduates chosen work focus upon completion of the program. We propose to train 104 graduate students from three disciplines: nursing, social work, and psychology, and a minimum of 80 community-based health care professionals in integrated healthcare settings. We are requesting a funding preference (qualification 1) because during the 2-year period, from 2018- 2020, the SSW and CON achieved a high rate of graduates working in MUCs. We are requesting a funding priority because our programs have demonstrated prior ability to train nursing, psychology, and social work students in integrated care settings. Training health professionals, preceptors, and students in evidence-based assessment and intervention will increase access to and availability of care, reduce behavioral health disparities, and promote the use of Evidence Based Interventions in Michigan's MUCs.