Addressing Behavioral Health Disparities in High Need Communities to Promote Health Equity

PURPOSE: The Substance Abuse and Mental Health Services Administration (SAMHSA), Center for Substance Abuse Prevention (CSAP) will provide an overview of the evolution of the interpretation, implementation, and monitoring of the Health and Human Services (HHS) directive to address health disparities within CSAP grant programs.  SAMHSA’s initiatives include a focus on providing substance abuse prevention programs, policies and practices to identified disparate populations in communities of high need.  From that directive, CSAP required Partnership for Success (PFS) grantees to submit a Health Disparities Impact Statement (DIS) explaining how they would address their most vulnerable populations.  Staff will discuss the initial analysis of those DIS’s from 68 grantees including states, jurisdictions and tribes/tribal organizations, demonstrating varying trends across the country, including many similarities between how each grantee chose their disparate population.  The discussion will include a review of efforts to identify long term outcome and monitoring strategies to ensure the behavioral health disparities are addressed.  The numerous gaps in data that were identified through the process of developing the DIS will be examined and participants will be encouraged to feedback on potential next steps for implementing and monitoring this important initiative. 

METHOD:Covering four cohorts, beginning in 2012 and the newest cohort starting in 2015, CSAP staff conducted a thematic analysis to identify any similarities or significant differences that could be found between the 68 grantees.  In addition to the DIS statements grantees develop a Quality Improvement Plan the outlines their approach to implement environmental strategies and evidence based interventions to improve access, use and outcomes to preventions programs/services. CSAP staff provides guidance, technical assistance and monitors the progression of the QIP.

RESULTS:The identification of high need communities and disparate populations revealed common as well as unique trends across the 68 grantees; including many similarities between tribal grantees and certain states grouped regionally.   CSAP  developed a web based reporting system that  collects  grantee accomplishments and challenges in addressing high need communities and reaching the most vulnerable in those communities.  The reporting system provides a comprehensive platform for data sharing and monitoring the access, use and outcome of prevention services.

DISCUSSION:  Every DIS is tracked to determine how each grantee continues to serve their identified disparate population.  The information is used to develop technical assistance strategies  for integrating substance abuse prevention strategies to reduce behavioral health disparities in those high need communities.  Outcomes from the DIS are used to understand program impact on the access, use and outcomes of grant activities on racial and ethnic minority populations.  The DIS positions SAMHSA to effectively address behavioral health disparities and advance the agenda to promote behavioral health equity.