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.

Cass County MAT

Principal Investigator: Bryan Victor

Grant Funder: Cass County Michigan Courts

Cass County Michigan received a grant award to establish an in-jail medication assisted treatment (MAT) for the opiate involved individuals who book into the Cass County Jail (CCJ). Primary stakeholders from Cass have engaged Western Michigan University
to assist with the data collection and analysis for this program. Cass is seeking content experts on two separate areas of practice, first is a community based first responder system, secondly, the establishment, maintenance and sustainability of an in-jail MAT program. The CBHJ team have content experts in both of these fields.

MI-CARES (SOR3)

Principal Investigator: Suzanne Brown

Grant Funder: Michigan Department of Health and Human Services (MDHHS)

The main objective of the MI CARES 3.0 grant is to engage additional medical schools in providing electives and other curricular activities through shared learning and resources. This grant aims to encourage medical school collaborations around training medical students on treating persons with a substance use disorder.

Hope HQ: Building a Community-based Program for Southeast Michigan Families

Principal Investigator: Luisa Kcomt

Grant Funder: Community Foundation for Southeastern Michigan

Hope HQ will offer a continuum of care consisting of an online knowledge & support center, coaches, navigators, and camps for bereaved children ages 5-17 and their caregivers who have experienced the death of a parent/significant person from drug overdose.

Wayne State University Center for Health Equity and Community Knowledge in Urban Populations (CHECK-UP)

Principal Investigator: Jason Carbone

Grant Funder: CVS Pharmacy, Inc.

Partnership for Advancing Substance Misuse Prevention Coalitions

Princial Investigator: Elizabeth Agius

Grant Funder: Michigan Department of Health and Human Services (MDHHS)

The Michigan Partnership to Advance Coalitions (MI-PAC) project aims to reduce the onset and progression of substance misuse and its related problems by supporting the development and delivery of state and community substance misuse prevention and mental health promotion services. Michigan's data documents infrastructure needs for two prevention priority areas: 1) a statewide coalition training and technical assistance program, and 2) funding to establish, reestablish, or enhance underserved regional or community prevention coalitions. Project goals include enhance statewide infrastructure to provide training and technical assistance to coalitions; increase capacity for communities to identify and address local substance use prevention concerns around tobacco, e-cigarettes, and marijuana; strengthen and expand implementation of the Strategic Prevention Framework; and implement standard improvement procedures to ensure use of high-quality programs, practices, and policies. Wayne State University School of Social Work will manage data collection, performance measurement, and quality improvement activities for the Department of Substance Use, Gambling, and Epidemiology. WSU will work with the Behavioral Health and Physical Health and Aging Services Administration (BHPHA) to ensure that all data collection and reporting requirements are fully met. WSU has experience collecting required GPRA data and using the SPARS system to inform implementation and identify areas for improvement. All coalitions will complete the standard and supplemental MRT tool. This will serve as the routine progress monitoring for the grant. WSU will document all technical assistance and coalition training provided by BHPHA. We will conduct an environmental scan of each targeted region to assess capacity and activities related to measure SPF knowledge and implementation efforts among community coalitions. WSU will also assist in identifying technical assistance and training needs for coalitions and conduct site visits to assure project progress and fidelity to evidence-based strategies being implemented.

Crisis Stablization Pilot Program - Project BF

Principal Investigator: Sheryl Kubiak

Collaborator: Shantalea Johns

Grant Funder: Michigan Department of Health and Human Services (MDHHS)

The Wayne State School of Social Work's crisis response credentialing program aims to support the development and expansion of a workforce with skills to work within co-response and mobile crisis. The project will offer cutting-edge education and training to individuals with direct practice experience working in mental health settings and college students enrolled in a professional program aimed at becoming mental health professionals. The credentialing program will provide education and skill-building courses that enhance crisis assessment and practice techniques necessary to intervene and perform skills-based support when responding to a crisis. WSU School of Social Work will develop the training modules and university credit courses around performing rapid clinical assessments, de-escalate, providing contextual diagnosis, and effectively evaluating the needs of individuals in crisis in the community. WSU School of Social Work will also manage the project's data collection and performance measurement, which will serve as the routine progress monitoring for the project.

Coalition, Women, and Recovery Services Evaluations

Principal Investigator: Elizabeth Agius

SSW Collaborator: Stella Resko

Grant Funder: State of Michigan Dept. of Health & Human Services - MDHHS

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 and evaluation for a set of new and/or expanding initiatives. Elizabeth Agius, the Manager of Community Partnerships, will serve as Principal Investigator of the performance assessment. The projects include prevention activities directed by Prevention Network, expansion of services including Medication Assisted Treatment in Women's Specialty treatment settings, and an evaluation of the use of peer recovery services, including new implementation of an assessment tool. For the prevention activities we will 1) track administration by Prevention Network to detail their grant activities, and 2) track monthly or quarterly activities by all funded projects. We will provide written summaries of these activities with the state and make recommendations about process improvements. For the women's specialty programming, we will interface with providers to gather information about client retention and use of medication assisted treatment for opioid use disorders. This will be reported quarterly to the state. In addition, as new evidence based practices are implemented, we will track usage and outcomes (to be determined). Finally, for peer recovery services we will create and launch a workforce development survey to better understand needs for training, job satisfaction and work conditions, 21-1831 Coalition, Women, and Recovery Services Evaluations PI: Agius, Elizabeth Page: 4 of 5 among other items. A full report will be provided to the state at the conclusion of the grant. The state will pilot the use of a Recovery Capital Assessment with select providers and we will analyze data from that tool to assess the variety of recovery supports available. Regular exploration of the data from the tool will help providers make program improvements to better serve clients.

Firearm violence prevention through community-engaged vacant property reuse: Application of Busy Streets Theory in Detroit

Principal Investigator: Rebeccah Sokol

Grant Funder: University of Michigan - U of M

The purpose of this study is to conduct a natural experiment to examine the effect of different types of vacant lose reuse projectsand of different levels of community engagement within reuse projectson total firearm crime incidents and injuries over time. Dr. Sokol has extensive research experience with expertise in youth trauma and violence prevention, firearm violence and injury prevention, and quasi-experimental and longitudinal analyses.

Michigan Project to Prevent Prescription Drug/Overdose-Related Deaths

Principal Investigators: Elizabeth Agius

SSW Collaborator: Stella Resko

Grant Funder: State of Michigan Dept. of Health & Human Services - MDHHS

The Michigan Project to Prevent Prescription Drug/Opioid Overdose-Related Deaths (MI-PDO) aims to reduce prescription drug/opioid overdose-related deaths and adverse events among residents 18+ in Calhoun, Genesee, and Wayne counties. Project goals include increase capacity of the high need communities to address the project's purpose, reduce access to opioids through implementation of safe prescribing, and enhance opioid education and naloxone distribution. Wayne State University School of Social Work will manage data collection, performance measurement, and quality improvement activities for the Office of Recovery Oriented Systems of Care. WSU will work with OROSC to ensure that all data collection and reporting requirements are fully met. WSU has experience collecting required GPRA data and using the SPARS system to inform implementation and identify areas for improvement. All subrecipients/target communities will complete the standard and supplemental MRT tool. This will serve as the routine progress monitoring for the grant. WSU will document all training participation and assess knowledge gains, in addition to follow up to assess kit usage. We will conduct an environmental scan of each targeted county to assess capacity and activities related to prescription drug overdose prevention, assist in identifying technical assistance and training needs for community providers, and conduct site visits to assure project progress and fidelity to evidence-based strategies being implemented.

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.

Substance Use Disorder Data Repository Coordination

Principal Investigator: Elizabeth Agius

Grant Funder: State of Michigan Dept. of Health & Human Services - MDHHS

The Michigan Substance Use Disorder Data Repository (SUDDR) website was created to allow users the ability to find data on various substance use topics. The target audience for the site includes local prevention/treatment agencies and coalitions. The site is meant to provide agencies the ability to: enable data-driven programming decisions, utilize data for grant seeking purposes, and to define the scope of a problem in a specific geographical location. The data is presented in visualizations that allow the data to be explored as interactive maps, bar charts and trendlines (or sparklines). One key feature of the website is the ability for users to download available data to be used in community planning and outreach documents. Key data sources include: The Michigan Profile for Healthy Youth (MiPHY), The National Survey on Drug Use and Health (NSDUH), and Statewide Opioid Hospitalization and Death Rates.

Substance Use Treatment Services for Pregnant and Parenting People

Principal Investigator: Elizabeth Agius

Grant Funder: State of Michigan Dept. of Health & Human Services - MDHHS

The Michigan Comprehensive Assistance for Family Success (MI-CAFS) initiative will enhance the continuum of care services for pregnant and parenting women and their families. Between 2017 and 2020, 1,100 female substance use treatment admissions were pregnant at admission, with 58% of those women reporting opioids as their primary substance. The purpose of the MI-CAFS project includes: 1) increase outreach, engagement, screening and assessment; 2) expand enhanced women's services; 3) increase pregnant and parenting women's care in opioid health homes; 4) deliver women and family-specific evidence-based practices; and 5) increase medication assisted treatment to those with an opioid use disorder. Wayne State University School of Social Work will manage data collection, performance measurement, and quality improvement activities for the Office of Recovery Oriented Systems of Care. WSU will work with OROSC to ensure that all data collection and reporting requirements are fully met. WSU has experience collecting required GPRA data and using the SPARS system to inform implementation and identify areas for improvement. For this project we will track increased service utilization and use of evidence-based practices in PIHP Regions 2 and 7. In addition, we will participate in regular project meetings and annual site visits to provide OROSC with information to improve programming. Finally, all evaluation and data collection will be summarized in an annual report.

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

Grant Funder: US Health Resources and 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. We are submitting this one application for funding opportunity number HRSA-21-089 and requesting a total of $1,920,000. 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.

Community Health Worker Academy: Workforce Development to Improve Urban Health Care and Advance Health Equity

Principal Investigator: Stella Resko

Grant Funder: Health Resources & Services Administration

The Division of Kinesiology, Health and Sport Studies in the College of Education at Wayne State University requests $2,618,267 from the HRSA Community Health Worker Training Program (CHWTP) funding program over three years to launch a project called "Community Health Worker Academy: Workforce Development to Improve Urban Health care and Advance Health Equity" in order to enhance and bring to scale our Community Health Worker Academy. The project would take place in three counties in Metro Detroit (Wayne, Oakland, Macomb) focusing on the underserved communities in this region determined by their Social Vulnerability Index score, health disparities relative to other regions, documented health care and public health workforce shortage, impact from COVID 19, racial and ethnic diversity, and socio-economic status. The project combines the interdisciplinary expertise of faculty and staff from the College of Education, School of Medicine, and School of Social Work, as well as the Michigan Community Health Worker Alliance and many regional health care and public health partners. The project will expand and extend/upskill the CHW workforce by officially certifying 140 trainees as CHWs (expanding), providing comprehensive Foundational and Advanced Specialized trainings (extending/upskilling), and placing them in Registered Apprenticeships and internships in integrated care teams at health care and public health organizations and agencies. The entire program integrates the Public Health Core Competencies, including training in health equity, social determinants of health, emergency response, treatment, vaccine hesitancy, COVID 19, career development and job preparation, and digital literacy among many others. At least 60% of the trainees will represent underserved communities, and will receive job placement assistance to so they gain employment as CHWs within one year of Academy completion.

Stepping Up Technical Assistance Initiative FY2023

Principal Investigator: Sheryl Kubiak

Grant Funder: Michigan Department of Health and Human Services

Although several Michigan Counties have committed to 'Stepping-Up', there is often insufficient data to identify the target population and to inform efforts to develop a system-wide response. In an effort to assist these actively involved counties that are not currently receiving resources from the Governor's Diversion Council the Michigan Department of Health and Human Services will offer opportunities for technical assistance from leading experts. Dr. Sheryl Kubiak, evaluator of pilot diversion projects statewide, will lead a team of university research faculty and staff, to engage county leaders in discussion, data collection, problem identification and problem-solving processes in each county. The process will be organized around the six questions posed in the Stepping Up framework, but particularly focus on these questions: Do we conduct timely screening and assessments? Do we have baseline data? Have we conducted a comprehensive process analysis and inventory of services?

Providing Technical Assistance to Communities in Michigan on Opiods Remediation

Princial Investigator: Stella Resko

Collaborator: Sheryl Kubiak

Grant Funder: Michigan Public Health Institute (MPHI)

Long term, the goal of this collaborative is to implement a technical support system wherein experts across MSU, UM, and Wayne State provide communities with timely and unbiased community needs assessment, analysis with evidence-based recommendations, implementation support and EVALUATION of efforts to prevent and treat opioid use concerns. During the next year, the team will provide community engagement, support and planning assistance to collaborate, coordinate, and develop the mechanisms, organization, and processes for evidence-based fund appropriation. In future years, the team will provide implementation technical assistance.

Michigan Project to Prevent Prescription Drig/Overdose-Related Deaths

Principal Investigator: Liz Agius

Collaborator: Stella Resko

Grant Funder: Michigan Department of Health and Human Services

E Substance Use Disorder Education

Principal Investigator: Sheryl Kubiak

Grant Funder: Michigan Department of Health and Human Services

The overdose epidemic continues to be one of the most pressing public health crises in US history, with more than a half million deaths since 2000, and evidence that deaths are increasing (Ahmad et al., 2020). Carceral settings have emerged as a life-threatening risk factor as overdose is the leading cause of death for persons leaving county jails (Binswanger, 2013; Binswanger et al., 2007; Joudrey et al., 2019). A majority of these overdose deaths are opioidrelated and a growing number of studies suggest that providing all three forms of FDA approved medication for opioid use disorder (MOUD)methadone, buprenorphine, and naltrexoneto persons in jails and prisons can reduce overdose rates by more than 30% (Macmadu et al., 2021). Correctional facilities have a unique and critical opportunity to intervene in the overdose epidemic yet few offer these evidence-based medications, often related to stigma (Wakeman & Rich, 2015, 2018). In 2019, with funding from the Michigan Opioid Partnership, the Center for Behavioral Health and Justice (CBHJ) at the Wayne State University School of Social Work launched the Opioid Treatment Ecosystem (OTE) initiative, a technical assistance project aimed at strengthening community-based substance use disorder (SUD) treatment at its intersection with criminal-legal systems. A key part of this initiative is the implementation of MOUD in county jails which the CBHJ has successfully facilitated in five counties to-date. The CBHJ has experience facilitating the implementation of MOUD in county jails that are both large (e.g. Kent County, with a jail capacity of approximately 1100) and small (e.g. Monroe County, with a jail capacity of 363) with multiple configurations of public and for-profit providers and jail data management systems, with a consistent focus on behavioral health that includes SUD and mental health treatment across the entire criminal-legal spectrum. The overarching goal of the OTE is not to simply "check off the MAT box" but to eradicate stigma and achieve culture change that fosters the standard of care for opioid use disorder (OUD) as a chronic care condition and empowers correctional staff to consider the critical role they play in combatting the overdose epidemic. To accomplish this, the CBHJ will: 1) implement the "OTE Jail MOUD Model" in nine jail facilities over three years; 2) develop MOUD training materials to streamline future efforts. This bottom-up approach will invite new jails and community providers into the existing OTE Community of Practice to share progress, barriers, and learn from each other; and 3) measure culture change among implementation stakeholders using validated survey tools.

Michigan Overdose Data to Action - Integration with Correctional Facilites

Principal Investigator: Sheryl Kubiak

Grant Funder: Michigan Department of Health and Human Services

The nexus of criminal justice and community-based treatment has substantial capacity for mitigating the effects of the overdose crisis. With the SAMHSA State Opioid Response funds, the MDHHS has provided millions to help expand treatment into correctional settings in Michigan. This has included funding to the Michigan Opioid Partnership, and in turn the Center for Behavioral Health and Justice at Wayne State University, who has developed the Opioid Treatment Ecosystem Initiative (OTE). The OTE is a technical assistance framework aimed at strengthening community-based substance use disorder (SUD) treatment at the intersection of criminal-legal systems. For opioid use disorder (OUD), no treatment has stronger evidence supporting its efficacy than medications for opioid use disorder (MOUD), which includes methadone, buprenorphine, and naltrexone. Key to this is the implementation of MOUD in county jail, but the OTE initiative also aims to expand treatment ecosystems prior to and following incarceration. As part of the Michigan Overdose Data to Action we are proposing two strategies that build on this treatment ecosystem approach. The first is to integrate fatal and nonfatal overdose data with local county level jail management information system data to better understand the impact of MOUD expansion into county jails. The second is to improve post-exit ecosystems by providing harm reduction training to peer recovery coaches working in criminal-legal settings.

State Opioid Response Evaluation

Principal Investigator: Liz Agius

Collaborator: Stella Resko

Grant Funder: Michigan Department of Health and Human Services

The State of Michigan Department of Health and Human Services, Behavioral and Physical Health and Aging Services Administration will contract with Wayne State University School of Social Work (WSU) to conduct data collection and performance measurement for a set of new and/or expanding initiatives. Elizabeth Agius, the Manager of Community Partnerships, will serve as Principal Investigator of the evaluation activities. The projects include initiatives to a) improve the state infrastructure for individuals with an OUD and StUD, b) train PIHP and provider administration on infrastructure improvements, train provider staff on evidence based interventions and fidelity measures, and increase educational opportunities for certified peers., c) implement evidence based prevention and treatment interventions with accompanying fidelity instruments to ensure that the quality of the intervention is consistent across the provider network, and d) expand overdose education and harm reduction services including naloxone distribution, e) increase supportive peer services to probationers and parolees, f) support the use of peers in medical and community settings, g) expand recovery friendly communities that include housing and employment support, h) improve access for racial and ethnic minorities, and i) disseminate educational messaging regarding anti-stigma, OUD, and StUD. For all funded activities WSU will track subgrantee administration to detail their grant activities and track monthly or quarterly activities. WSU will provide written summaries of these activities with the state and make recommendations about process improvements annually. WSU will also oversee GPRA data collection and reporting of client-level data into SPARS. All individuals receiving SOR 3 treatment or recovery services will complete the required GPRA client level instrument. WSU will provide training and technical assistance to grant funded treatment and recovery service providers to collect the client-level outcome measures tool data at intake, discharge, and six months post intake; with an emphasis on the area of completing the six-month follow-up GPRA inorder to achieve a rate of 80%.

State Opioid Response Naloxone Vending

Principal Investigator: Sheryl Kubiak

Grant Funder: Michigan Department of Health and Human Services

In Michigan and across the country, overdose rates increased in 2021 and were primarily driven by illicitly manufactured fentanyl, an extremely potent synthetic opioid. Fortunately, there is an antidote for opioid overdose that is highly effective naloxone (commonly known by the brand name Narcan®). Naloxone is a safe and easy to use medication that is approved by the Food and Drug Administration. It works by knocking opioids, including fentanyl, off the receptors in the brain and blocking them from re-attaching, thereby reversing their effects. Since 2016, there has been a standing order in Michigan that makes naloxone available to the general public without a prescription. However, it can be costly to purchase the medication from a local pharmacy, and many pharmacists carry stigma, bias, and misinformation that make it difficult to purchase from a pharmacy even when cost is not a barrier. Further, community organizations that distribute naloxone for free often require individuals to complete lengthy trainings among other requirements to obtain a kit. County jails, harm reduction agencies, treatment centers, homeless shelters, hospitals, and other organizations have a critical opportunity to prevent overdose deaths by increasing naloxone distribution in their communities. One strategy for achieving widespread distribution of naloxone with few resources and limited staff time is through the use of public health vending machines. The use of vending machines to distribute free naloxone to priority populations that are at the highest risk for overdose has been successful in several Michigan counties and across the country. Naloxone Vending Machines The Center for Behavioral Health and Justice (CBHJ) at Wayne State University has experience implementing public health vending machines for the purpose of widespread naloxone distribution. By utilizing grant funds from the Michigan Overdose Data to Action (MODA) project, the CBHJ previously purchased and implemented 15 public health vending machines in county jails, community treatment centers, harm reduction agencies, and other public spaces throughout Michigan. In addition to distributing naloxone, several sites have selected to include other harm reduction supplies including fentanyl testing strips, first aid materials, and information about local resources. Each naloxone vending machine can be customized to fit the product or packaging that a site wishes to include in their machine. With a focus on the intersection between behavioral health and the criminal/legal system, the CBHJ conducted an early analysis of MDHHS naloxone portal order history for the seven jails that implemented a naloxone vending machine in 2021. Among these seven sites, there were 1,236 naloxone kits ordered in the three months before the vending machines were implemented and 6,060 ordered in the three months following implementation. Overall, this represents a 4.3x increase in the number of naloxone kits ordered and distributed in jails during this pre/post implementation period. Notably, four of these seven jails began distributing naloxone for the first time. Analysis of order history for non-jail sites as well as an eighth jail-based site that implemented its machine in May 2022 has not yet been completed. In addition to the CBHJ's success in implementing these machines, a multitude of organizations locally and across the country are also working to implement vending machines. The CBHJ participates in a bi-monthly convening with organizations across the country and fields dozens of inquiries from agencies within Michigan and across the country who are interested in implementing vending machines. The CBHJ is seen as a leader in best practices for coordinating the logistics and implementation of naloxone vending machines.

Behavioral Health Unit

Principal Investigator: Sheryl Kubiak

Grant Funder: Wayne County Probate Court

The Center for Behavioral Health and Justice (CBHJ), within the School of Social Work at Wayne State University, is committed to the work being conducted by the Wayne County Jail/Mental Health Initiative (WCJ/MHI) and its 30+ partner agencies to improve the diversion and deflection of individuals with behavioral health needs who are involved in the Wayne County criminal/legal system. Operating across the Sequential Intercept Model, current CBHJ projects span the criminal/legal continuum - from enhancing community supports as a preventative approach, to improving community response to behavioral health crises, to early identification of behavioral health concerns at jail intake, to improving continuity of care by bridging re-entry of individuals from jail or prison to the community. Our focus and engagement of stakeholders at the county-level is key to both the successful implementation of state-led priorities and the identification and resolution of barriers that impede local progress. Since 2019, the CBHJ has provided external facilitation to the WCJ/MHI as the body has focused on intercepts 0, 1, and 2. As part of our ongoing facilitation of the WCJ/MHI, the Wayne County Probate Court has requested the services of the CBHJ to support the creation of a behavioral health unit (BHU). The purpose of the BHU is to assist in the implementation of the goals of the Wayne County JailMental Health Initiative (WCJMHI) and Hospital Initiative, including promotion of increased utilization of the Assisted Outpatient Treatment (AOT) process.

Evaluation of Harm Reduction Street Outreach Teams - YR3

Principal Investigator: Bethany Hedden

Grant Funder: Rutgers, The State University of New Jersey

Since the 1950s street outreach programs have addressed issues such as homelessness, violence, and disease prevention.
Outreach teams informed by the philosophy and practice of harm reduction have demonstrated ability to connect vulnerable
persons who use drugs to health care services.2 Through the Division of Mental Health and Addiction (DMHA), the state of
Indiana is implementing ten (10) harm reduction street outreach (HRSO) teams for two-years. The HRSOs are intended to consist
of two outreach workers per team who will engage with persons who use drugs in the community to provide information on and
referrals to treatment services and distribute harm reduction kits. To understand the implementation processes and
effectiveness of these teams, this evaluation is guided by the Exploration, Preparation, Implementation, and Sustainability
framework, which seeks involvement from stakeholders who understand the external and internal context towards this
innovative programming.