FY 2024 behavioral health service expansion - this initiative, expansion of BH & SUD services for boston's underserved communities, will significantly increase harvard street's behavioral health and…

FY 2024 behavioral health service expansion - this initiative, expansion of BH & SUD services for boston's underserved communities, will significantly increase harvard street's behavioral health and substance use disorder programming and its capacity to meet the needs of the low-income, racially and ethnically diverse, and socioeconomically disadvantaged populations we serve. Located in the heart of boston's most underserved neighborhoods of dorchester, roxbury and mattapan, harvard street serves a population that is predominantly bipoc (black, indigenous, people of color) with more than 40% identifying as ethnically latinx and half preferring a language other than english. Many are new immigrants, refugees, single-mother families, at-risk youth, members of the lgbtqi+ community, elderly, disabled and other vulnerable populations such as unhoused individuals, veterans, formerly incarcerated, as well as those engaging in high-risk drug activities or suffering from substance use disorder. The rates of substance use disorder and opioid overdoses have been rising dramatically in our community since 2017, with boston experiencing a 40+% increase in opioid-related deaths - the majority of which are fentanyl-associated. The most dramatic increases in overdoses have occurred in boston's black and latinx communities, with annual opioid mortality rates 66% and 31% higher than their white counterparts, respectively. Young adults are particularly vulnerable. Lack of education, along with lack of access to harm reduction, moud (medications for opioid use disorder), SUD counseling, peer support, and inpatient referrals all contribute to the continued rise in the deaths. Likewise, we've witnessed the onset of a mental health crisis in bipoc populations, especially among youth - particularly concerning for transgender youth (22% attempting suicide). All ages in our community are affected by depression, anxiety, self-harming behaviors, obsessive-compulsive disorder, post-traumatic stress disorder , substance use disorder or other concerns. Many of these disorders may be linked with trauma, systemic racism, domestic abuse, or neighborhood violence and loss. The need for increased BH/SUD services in boston's low-income, communities of color is clear, and yet many do not seek treatment due to shame, stigma, lack of trust in healthcare, inability to pay and cultural beliefs. Furthermore, the social determinants of health (SDOH) barriers faced by those we serve are vast and include language and cultural barriers, economic barriers, lack of transportation or childcare, food insecurity, lack of adequate housing or digital divide. Those who are struggling with basic needs, like food or housing, are unlikely to seek needed care for addiction or prioritize their mental health. The stress of their struggles only drives them further from treatment and recovery. We will engage those hardest to reach with a culturally competent and unbiased approach - both within the health center and across the community - through partnerships with community-based organizations and via our mobile infectious disease team. We will increase the number of patients receiving mental health and SUD services, including those receiving moud, by encouraging referrals from partners, beginning moud, training staff, and adding recovery coaching, peer youth support, educational outreach, and naloxone distribution. By integrating BH/SUD with primary care, dentistry, and other departments, we will better screen and identify patients in need. As an affiliate of boston medical center (BMC), we will refer those in need of urgent or residential treatment to BMC's faster paths to treatment program and will provide follow-up RE-entry support. We will help patients overcome stigma, provide harm reduction materials, and gain trust by offering needed SDOH support (food pantry, computer lab, travel vouchers etc.). Added staff will include 3.5 SUD & BH social workers, 1 youth-focused CHW, 1 recovery coach, and a .5 FTE psych NP. H80CS2900