Distance Training and Implementation Supports to Scale Up Integrated Treatment for People With Co-occurring Mental Health and Substance Use Disorders

Abstract

Objective: Integrated, evidence-based treatment for co-occurring severe mental illness and substance use disorder (co-occurring disorders) reduces substance use, hospitalization, homelessness, incarceration, and treatment costs and promotes individuals’ recovery, independent living, and employment. This report describes and characterizes early uptake of New York State's Web-based training and distance implementation supports to promote statewide dissemination of integrated, evidence-based co-occurring disorders services. Methods: Thirty-five half-hour online modules provide training on integrated evidence-based co-occurring disorders treatment. Distance supports for implementation include monthly webinars, phone calls, and virtual learning communities. The authors calculated the proportion of programs with one or more practitioners who accessed the Web-based resources and the cumulative number of modules completed as an indicator of the reach of the Web-based approach to scaling up an innovation. They also calculated the number and proportion of staff per program who accessed the Web-based resources as an indicator of critical mass that may be needed for sustainability. Results: Of 369 programs participating in the initiative, 232 (63%) had at least one staff member accessing the online modules; 30% of programs had one-third or more of their staff accessing the online modules, and total attendance at webinars was close to 700. Staff who started taking the training averaged a little more than 6 modules, with 8,862 modules completed across staff to date. Conclusions: Early uptake of the New York State initiative suggests that distance learning and supports may be a feasible vehicle to train practitioners in large treatment delivery systems.

Keywords:

• co-occurring
• mental health
• substance use
• e-learning
• distance learning
• training
• implementation
• dissemination
• uptake
• integrated treatment

ACKNOWLEDGMENTS

The authors would like to thank the staff at the Dartmouth Psychiatric Research Center (http://www.dartmouth.edu/~prc/) for their content expertise, particularly Robert E. Drake, MD, PhD, and Mark P. McGovern, PhD; Jennifer Milner and Barbara Gardner at Allen Communication Learning Services (http://www.allencomm.com/) for courseware development; Bob Griffiths of FireDancer Productions, Inc. (http://firedancer.tv/) and Sharon Shepard-Levine of Twin Star Productions for producing the video recovery stories, skills demonstrations, and expert panels contained within the online training modules; and Cornerstone OnDemand (http://www.cornerstoneondemand.com/lms-learning-management) for providing the learning management system services to host and track the online training. They also extend their gratitude to the many consumers, practitioners, and experts who shared their stories with them in the videos. They would also like to thank their New York State Office of Mental Health partners, particularly Jeff Gleba, MS, CRC, and Commissioner Michael Hogan, as well as their New York State Office of Alcoholism and Substance Abuse Services partners, particularly Patricia Lincourt, LCSW, and then-Commissioner Karen Carpenter-Palumbo, along with the Nathan Kline Institute Center of Excellence in Culturally Competent Mental Health. Finally, they would like to recognize Dean Fixsen, PhD, for his ongoing consultation and Forrest (Rusty) Foster, MSW, for overseeing the distance implementation supports. This work was financially supported by the NYS Office of Mental Health and by the NYS Office of Alcoholism and Substance Abuse Services. Earlier versions of the data were presented at the 4th Annual National Institutes of Health Conference on the Science of Dissemination and Implementation on March 21, 2011.

[Supplementary materials are available for this article. Go to the publisher's online edition of Journal of Dual Diagnosis for the following free supplemental resource: FIT Course List Grouped by Topic.]