Integrating Mental Health and Addiction Services for Vulnerable Families

Investigators at the University of Michigan School of Public Health documented different models of integrating mental health and addiction treatment services, housing, juvenile justice and vocational training for families in need. The goal was to find examples of local service-integration models to replicate in other communities.

Literature Review: The investigators conducted a detailed literature review through online databases to find peer-reviewed articles describing integrated-care delivery models for mental health and addiction services. They summarized the research in an unpublished manuscript that traces the evolution of integrated services for mental health, addiction treatment, primary care, criminal justice, housing and other social services.

Case Studies: Principal investigator Kyle Grazier, PhD, compiled a list of 30 potential sites for case studies, whittling the number to eight through telephone interviews. She spent two to three days at each of them and drafted case studies on six. She selected the six sites because they differed in design, were the most developed and comprehensive and appeared most replicable.

In all of the models, families, physicians, judges, counselors and other practitioners established links with social services or support groups. Some of the models also integrated mental health and addiction services with primary medical care, while others created links with criminal justice. All of the projects relied on multiple sources of financing to fund services.

Key Findings

In a report to RWJF, Grazier identified the following elements common to integrated systems for these vulnerable populations:

  • A clearly defined vision for what the structure of an integrated system would look like and which service providers, community groups, schools and other organizations would be involved
  • An energetic and organized manager (either the project's visionary or someone else) willing to champion the project and recruit team members
  • Financing streams that could be gathered and focused on the project, such as Medicaid funds or state and federal block grants
  • Active and ongoing involvement from families and community groups, whose members are likely to have first-hand information about unmet service needs and alternative approaches to treatment and recovery
  • A set of metrics to measure and track outcomes
  • An emphasis on open communications, so all participants—including service providers and community groups—are kept up-to-date on the project's activities and outcomes