FY 2024 behavioral health service expansion - the aim of the proposed project is to expand mental health and substance use disorders (SUD) services and to develop and implement a medication for opioid…

FY 2024 behavioral health service expansion - the aim of the proposed project is to expand mental health and substance use disorders (SUD) services and to develop and implement a medication for opioid use disorder (MOUD) program at castañer general hospital (CGH) and the polyclinics in adjuntas and jayuya. The population of focus of the initiative will be children, adolescents, adults and older adults from castañer and the municipalities of adjuntas, jayuya, lares, maricao and yauco. Puerto rico has a high prevalence of mental health problems. Data from the mental health report from the puerto rico health insurance administration (2022) shows that 18% of the puerto rican population between the ages of 18 and 64 suffers from an anxiety disorder, 12.5% of the population suffers from a mental health disorder and 17.3% of the adult population has a major depressive disorder. The puerto rico opioids dashboard reported 854 opioid-related deaths in 2020. The health department of puerto rico (2023) reported an average of 287 suicides between 2020 and 2023. In puerto rico 4.6% of the population reported heavy alcohol drinking and 6.4% consumes tobacco daily (brfss, 2022). The comprehensive community health needs assessment (CCHNA) (2021) for CGH revealed that 36% of adults affected by mental health disorders did not receive services and 50% of the respondents consider psychiatric specialists necessary. Only 6% of respondents indicated to have access to mental health services when needed. CGH is the only mental health and SUD service provider in our municipalities. The MOUD service is nonexistent in the area, and this initiative will let US provide this needed service. This services provision GAP is expected to be met by the proposed initiative. The CCHNA (2021) indicates important challenges that the population faces to receive health services: unemployment, unaffordable medical costs, low income - 86% of residents below 200% of the federal poverty level-, insufficient providers, lack of transportat ION and unawareness of available resources. A part-time psychiatrist, two full-time clinical psychologists, a full-time substance use counselor and a full-time nurse practitioner will be hired for the provision of the mental health and substance use disorders (SUD) services and the implementation of the medication for opioid use disorder (MOUD) program. The availability of these staff will allow the increase of access to mental health and SUD services in primary care. Services will be culturally responsive and patient-centered. The psychiatrist will provide services to patients with severe mental health symptoms and SUD. One of the clinical psychologists will develop and implement group therapy modules for conditions such as depression, anxiety, sleep disorder, and post-traumatic stress, among other services. Agreements with non-profit and governmental organizations will be develop to allow the CO-location of the second clinical psychologist in their facilities to provide mental health and SUD services to patients with limited access to our clinics due to the lack of transportation and the long distances in the rural area to access services. The substance counselor will implement the outpatient MOUD program. Three community health workers will be hired to educate communities and patients about mental health and SUD, raise awareness about stigma and discrimination that may result in barriers to access mental health and SUD services, help patients navigate systems (health services, social services, utilities, housing) to facilitate access to resources and services. The proposed project will develop an elearning program for PCP and BHC to improve knowledge on behavioral health and problematic substance use in primary care and will promote awareness about stigma and discrimination that may result in barriers to access mental health and SUD services. The proposed initiative will allow access to mental health and SUD services improving wellness and quality of life for the rural area.