Baltimore Substance Abuse Sytems inc.
FY2012 Strategies to Prevent Substance Use and Misuse
One North Charles Street, Suite 1600
Baltimore, Maryland 21201
Phone: 410.637.1900 Fax: 410.637.1911
E-Mail: Web:
Table of Contents
Introduction2
Environmental Approach for Prevention and Evaluation 3
Strengthening Families Program5
Community Prevention Schools8
School-Based Treatment10
Expanded School Mental Health12
Expanded School Behavioral Health Initiative13
Summary15
References16
Introduction
The prevention services offered by the Baltimore Substance Abuse Systems, Inc. (bSAS) are based on six strategies:
1.Information – newsletters, speakers, special events, Internet-based content, and advertising
2.Education – life skills training, problem-solving, leadership skills training, and conflict resolution
3. Problem Identification – hotlines, parent groups, and student assistance programs
4.Alternative Activities – field trips, inter-generational programs, arts, clubs, and sports
5.Community Mobilization and Support – supporting and coordinating groups that share goals to solve problems
6.Environmental and Social Policy Change – efforts to identify, create and change relevant public policies, ordinances, and laws to benefit the community
Several evidence-based programs are available to Baltimore City residents to prevent substance use. The programs include the Strengthening Families Program (SFP), Community Prevention Schools, School-Based Treatment, the Expanded School Mental Health (ESMH) program, and the Expanded School Behavioral Health Initiative (also known as the 6th grade initiative; ESBH). These programs allow bSAS to support children and families. The specific programs will be describedin the sections that follow. The sections will also display and describe the geographic variation in programs. To insure proper allocation of services the City was divided into four categories using North Avenue and Charles Street. Quad 1 is the northwest quadrant, Quad 2 is the northeast quadrant, Quad 3 is the southwest quadrant, and Quad 4 is the southeast quadrant.
Environmental Approach for Prevention and Evaluation
Beginning FY2011 and moving forward, bSAS will be required by the Alcohol and Drug Abuse A to spend 50% of it’s annual prevention budget on environmental strategies. ADAA defines environmental strategies as prevention efforts aimed at changing or influencing community conditions, norms and standards, institutions, structures, systems, and policies that contribute to substance use and consequences.
In an environmental prevention model, the focus on addressing substance use and consequences shifts from an individual focus to an environmental focus, potentially impacting every member of a target population. Environmental prevention strategies fall into several categories, including:
- Reducing retail access
- Reducing social access
- Changing social norms
- Restricting promotions
- Increasing perceived risk of use
- Increasing pricing
- Strengthening enforcement
All funded environmental strategies, programs, practices, and policies must be evidence based (based on research findings) as described below.
Previous work on social disorganization and social control theories (Hirschi, 1969; Robert, 1999) show that living in neighborhoods characterized by high rates of poverty, high mobility(Molina,Alegra & Chen, in press), and poor social cohesion (Sampson, Raudenbush & Earl, 1997; Sampson, 2003) increase the likelihood that residents will have poorer health outcomes. As a result, there is a growing interest in public healthin assessing how neighborhoodenvironmental contexts affect health and wellbeing (Berkman & Kawachi, 2003; Diez Roux & Mair, 2010).
Understanding how the neighborhood environment influences health behaviors is particularly relevant for substance use prevention. Research suggests there is an association between neighborhood characteristics and substance use (Silver, Mulvey & Swanson, 2002; Galea et al., 2007).Neighborhood exposure to drug activity, neighborhood deprivation (Galea, Rudenstine & Vlahov, 2005) such as abandoned buildings (Spelman, 1993; Furr-Holden et al., 2011), and violence (Furr-Holden et al., 2008) have been shown influence drug use and are therefore potential areas of intervention. Substance use prevention efforts must consider the multiple domains of risk (individual and environmental) and have multiple layers of intervention efforts to address these risks (Spooner, 2005).
In recent years, public health researchers and practitioners haveused Geographic Information Systems (GIS) to identify areas with unmet substance abuse treatment and prevention services (Walker, Mason, Cheung, 2006; Perron et al., 2010).GIS can spatially locate areas with unmet need at the street or neighborhood level rather than using larger boundaries such as zip code or county. This more specific spatial representation allows policy makers to focus on very specific areas (if desired) such as the blocks within a specific city council district. To ensure substance use prevention and treatment resources are allocated to those in need across the City, bSAS has expanded its evaluation of areas with unmet need from that based primarily on client self-report of residence to now incorporate data demonstrating geographic evidence of substance use and unmet need.The evaluation of the allocation of substance use prevention strategies targeted to youth and families,(1) Strengthening Families Program (SFP), (2) Community Prevention Schools, (3) School-Based Treatment, (4) the Expanded School Mental Health (ESMH) program, and (5) the Expanded School Behavioral Health Initiative (also known as the 6th grade initiative; ESBH), employs the use of GIS to ensure adequate coverage of services across the City.
Strengthening Families Program
“The Strengthening Families Program (SFP) is a nationally and internationally recognized parenting and family strengthening program for high-risk and regular families. SFP is an evidence-based family skills training program found to significantly reduce problem behaviors, delinquency, and alcohol and drug abuse in children and to improve social competencies and school performance. Child maltreatment also decreases as parents strengthen bonds with their children and learn more effective parenting skills.” – Strengthening Families Program.org /SFP is a 14 session resiliency training program for Baltimore families. There are age-specific programs for youth 3-5 years, 6-11 years, and 12-16 years. A typical weekly two and a half hour session includes a half-hour family meal, one hour separate youth and parent skills-building session, and a one hour family session to practice the skills learned in the separate sessions. SFP has been proven to increase positive parenting, parental supervision, parental involvement, increased child social skills, family cohesion, and family communication. Decreases in parental substance abuse, parent and child depression, child aggression, child hyperactivity and child concentration problems have also been observed.
Strengthening Families Program Utilization# Families referred / # Families enrolled / # Parents enrolled / # Children enrolled / # Families completed
FY 2011
Mean
Total / 15
75 / 9.4
47 / 9.6
48 / 10.8
54 / 5.2
26 (55.3%)
FY 2012
Mean
Total / pending
FY=Fiscal year, July 1 – June 30.
The map reflects programs in 2011 and 2012. The map shows that there are three sites in Quad 1, one site in Quad 2, and four sites in Quad 3. As illustrated on the table below, two providers, Northwest Baltimore Youth Services and Family Tree, provide services to two sites each.
Provider / Site / Address
Academy of Success / Academy of Success / 200 S Franklintown Rd
Leaders of Tomorrow Youth Center / Rognel Heights / 4300 Sidehill Road
Mind, Power, Health / Harbor City High School / 2555 Harford Rd
Camp Farthest Out / Douglas Memorial Community Church / 1325 Madison Ave
Northwest Baltimore Youth Services / 3319 West Belvedere Ave / 3319 West Belvedere Ave
KIPP Ujma Village Academy / 4701Greenspring Avenue
Family Tree / Empowerment Academy Empowerment Academy Elem/Middle / 851 Braddish Avenue
Gaudenzia / 4617 Park Heights Avenue
Community Prevention Schools
Community Prevention Schools are partnerships between the school and the community to foster a safe and drug free environment for youth. The goals are to prevent violence, alcohol, tobacco, and drug use in and around schools, and to engage parents and the community in these prevention efforts. To assist in these efforts, Community Prevention Schools have additional programming that includes age and developmentally appropriate violence and substance use prevention programs, trainings for members of the community on substance use prevention, activities that involve community prevention providers to further communicate the school and community’s commitment against violence and substance use, /trainings for staff on how to
identifyyouth in crisis and how to
makeappropriate referrals, and
haveincreased school security
that may include security
personnel,surveillance cameras,
and other monitoring technology.
The bSAS supports two Community Prevention Schools in Northeast Baltimore. Engaging and supporting high-risk communities in substance use prevention efforts demonstrates a shared commitment to improving the learning and living environments of the City’s youth.
Community Prevention School SitesSchool / Address
Barclay Elementary Middle / 2900 Barclay St.
Guilford Elementary Middle / 4520 York Rd
School-Based Treatment
School-Based Treatment provides direct services to students and educational services for staff within the school environment. Counselors are available at schools to assist youth at high risk for substance use and violence. In addition, counselors facilitate trainings for teachers on substance use prevention and education.School-Based Treatment provides youth with convenient and consistent access to treatment services. Five providers offer support to 24 schools who serve hundreds of young people throughout the City. /
School-Based Treatment Sites
Provider / Site / Address
Harbel / Archbishop Curley / 3701 Sinclair Lane
Catholic High / 2800 Edison Highway
Digital Harbor High School / 1100 Covington St.
A.C.C.E. (Academy for College and Career Exploration) / 1300 W. 36th St.
Success Academy / 200 E. North Ave.
Maritime Industries Academy / 5001 Sinclair Lane
Woodholme Elem/Middle School / 7300 Moyer Ave.
Independence (attached to A.C.C.E.) / 1300 W. 36th St.
Institute Of Notre Dame / 901 N. Aisquith St.
Johns Hopkins Bayview / Friendship Academy of Science and Technology / 801 S. Highland
REACH Partnership School / 2801 St. Lo Drive
Patterson High / 100 Kane St.
Maryland Treatment Center-Mountain Manor / Heritage High / 2801 St. Lo Dr.
Achievement Academy at Harbor City High / 2555 Harford Rd.
Treatment Resources for Youth / Frederick Douglass High / 2301 Gwynns Falls Pkwy
Reginald F. Lewis / 6401 Pioneer Dr.
Northwest Baltimore Youth Services / Forest Park High / 3701 Eldorado Ave.
ConneXions Community Leadership Academy / 2801 N. Dukeland St.
Bluford Drew Jemison STEM Academy West / 2000 Edgewood St.
Edmondson High / 501 N. Athol St.
Baltimore Civitas School – Mid/High / 2000 Edgewood St.
Maryland Academy of Technology and Health Science – Mid/High / 4701 Greenspring Ave.
Institute of Business and Entrepreneurship (IBE) / 2000 Edgewood St.
Baltimore Liberation Diploma Plus High School / 2801 Dukeland St.
Expanded School Mental Health
Expanded School Mental Health (ESMH) provides a network of services in order to offer a full continuum of mental health services within schools. ESMHextends beyond traditional therapeutic approaches to include more compressive school mental health services such as school-wide health and wellness programs, early intervention programs, mental health promotion campaigns, and treatment services.ESMH services are provided under an interdisciplinary framework through partnerships with the school, families, and communities to ensure the mental health needs of students in traditional and special education settings are met.In 2011, there were 89 schools providing ESMH services. /
There were 101 schools providing ESMH services in 2012.
Expanded School Mental Health Service Utilization
# Participating schools / # Youth at participating schools / # Providers / # Youth receiving ESMH services
FY 2011
Total
Percent1 / 89
- / 41,579
- / 9
- / 6,9341
17%2
FY 2012 data will not be available until August 2012.
FY=Fiscal year, July 1 – June 30
1Unduplicated
2Denominator: Youth at participating schools
Expanded School Behavioral Health Initiative
Expanded School Behavioral Health Initiative (also known as the 6th grade initiative; ESBH) provides targeted mental health and substance use prevention services to 6th grade students at risk for drop-out in schools with Expanded School Mental Health (ESMH) services. Students eligible for ESBHhavefailed math grades, failed reading grades, excessive behavioral problems, excessive absences and attendance problems, and are able and willing to attend the program sessions. Students participate in the 11-13 session WhyTrylife skills program that aims to help students increase motivation, develop effective decision making and problem solving skills, avoid negative peer influences, and improve discipline. In addition, some students also participate in /the WhyTry collateral program, led
by an ESMHclinician, that offers
additionalsupport.There were35
schools that providedESBH in
2011 and 2012.
Expanded School Behavioral Health Initiative Utilization
# Youth Identified for program / # Youth transferred schools / # Youth Eligible / # Youth participated in life skills training / # Youth also receiving other school mental health services / # Youth referred to other services within the school
FY2011Total
Percent / 600
- / 85
14%1 / 515
86%1 / 510
99%2 / 66
13%3 / 57
12%3
FY2012Total
Percent / 686
- / 76
11%1 / 610
89%1 / 520
85%2 / 62
10%3 / 204
39%3
FY=Fiscal year, July 1 – June 30
1Denominator:Youth identified.
2Denominator: Youth eligible
3Denominator:Youth who participated in life skills training
School # / Site / Address
164 / Arundel Elementary/Middle / 2400 Round Road
343 / Baltimore Civitas Middle/High / 2000 Edgewood Street
378 / Baltimore IT Academy / 900 Woodbourne Ave
75 / Calverton Elementary/Middle / 1100 Whitmore Avenue
159 / Cherry Hill Elementary/Middle / 801 Bridgeview Road
97 / Collington Square Elem/Middle / 1409 N. Collington Ave.
27 / Commodore John Rodgers Elem/Middle / 100 N. Chester Street
207 / Curtis Bay Elem/Middle / 4301 West Bay Avenue
201 / Dickey Hill Elementary/Middle / 5025 Dickey Hill Road
160 / Dr. Carter Godwin Woodson Elem/Middle / 2501 Seabury Road
25 / Dr. Rayner Browne Elem/Middle / 1000 N. Montford Avenue
62 / Edgecombe Circle Elem/Middle / 2835 Virginia Avenue
42 / Garrison Middle / 3910 Barrington Road
235 / Glenmount Elementary/Middle / 6211 Walther Avenue
214 / Guilford Elementary/Middle / 4520 York Road
35 / Harlem Park Elem/Middle / 1401 W. Lafayette Avenue
210 / Hazelwood Elem/Middle / 4517 Hazelwood Avenue
215 / Highlandtown Elem/Middle #215 / 3223 E. Pratt Street
12 / Lakeland Elementary/Middle / 2921 Stranden Road
203 / Maree G. Farring Elem/Middle / 300 Pontiac Avenue
105 / Moravia Park Elementary/Middle / 6201 Frankford Avenue
220 / Morrell Park Elementary/Middle / 2601 Tolley Street
421 / National Academy Foundation / 500 N. Caroline St
81 / North Bend Elementary/Middle / 181 North Bend Road
163 / Patapsco Elementary/Middle / 844 Roundview Road
223 / Pimlico Elem/Middle / 4849 Pimlico Road
89 / Rognel Heights Elementary/Middle / 4300 Sidehill Road
4 / Steuart Hill Academic Academy / 30 S. Gilmor Street
13 / Tench Tilghman Elem/Middle / 600 N. Patterson Park Avenue
84 / Thomas Johnson Elem/Middle / 100 E. Heath Street
226 / Violetville Elementary/Middle / 1207 Pine Heights Avenue
134 / Walter P. Carter Elem/Middle / 820 E. 43rd Street
225 / Westport Academy Elem/Middle / 2401 Nevada Street
263 / William C. March Middle / 2050 N. Wolfe St
Other Prevention-Related Activities from FY2012
Maryland Strategic Prevention Framework (MSPF)
Underage Drinking Initiative in Greenmount East/East Oliver
The federal Substance Abuse and Mental Health Services Administration (SAMHSA) Center for Substance Abuse Prevention (CSAP) has awarded the Maryland Department of Health and Mental Hygiene’s (DHMH) Alcohol and Drug Abuse Administration (ADAA) a grant in the amount of $2,135,724 per year for five (5) years, beginning on July 1, 2009 for the purpose of establishing the Maryland Strategic Prevention Framework (MSPF) Program. Approximately 287,000 Marylanders aged 12 or older report past month use of illicit drugs and 2.5 million report past month use of alcohol, yet only 211,000 individuals are reached by prevention services. MSPF funds will be used to implement a cross-system statewide strategic prevention planning and services system. The overarching goals of the MSPF project are to: (1) prevent the onset and reduce the progression of substance use disorders, including childhood and underage drinking; (2) reduce substance related problems; and (3) build prevention capacity and infrastructure at the state, local and community levels. In 2011, BSAS received an award of approximately $70,000 as part of the MSPF. BSAS convened a MSPF advisory group and using a multi-step process identified target communities that are high-need and high-readiness. The Greenmount East Community was identified as the target geographic are for this initiative and the Oliver Community Association (OCA) is the selected agency who will deliver services and engage a community coalition focused on underage drinking prevention and reduction. The Oliver Community Association was selected in part because they have an active Drug Free Communities Grant and coalition (the East Baltimore Drug Free Coalition). The primary outcomes of the MSPF are to reduce past month alcohol use in youth age 12-20, past month binge drinking among youth aged 18-25, and to reduce alcohol-involved crashes involving youth age 16-25.
These funded programs are required to:
- Recruit Baltimore City children, youth and/or families for their BSAS-funded prevention efforts.
- Utilize data to identify prevention needs, gaps, and resources.
- Implement evidence-based programs and strategies that address identified gaps and needs.
- Implement strategies and programs with fidelity.
- Operate consistent with ADAA Conditions of Grant Award.
- Evaluate services and progress toward outcomes, including monthly reporting in the Minimum Data Set (MDS).
- Select and implement prevention practices that are culturally appropriate.
- Address sustainability.
- Stay abreast of ADAA program certification requirements and stay in compliance, with those requirements.
Funded program staff are required to:
- Meet ADAA Certification Standards for Personnel (when applicable)
- Be formally trained and/or certified in the program(s) they are delivering.
- Acquire and maintain Maryland prevention credentials (when applicable)
Prevention-Related Programs funded through other BSAS mechanisms
Promoting, Training, and Implementation of Alcohol and Other Drug Screening, Brief Intervention, and Referral to Treatment (SBIRT) in High-Risk High Schools
BSAS has contracted with The Mosaic Group to provide SBIRT training in 6 Baltimore City Public High Schools to high school staff and in-house clinicians. The high schools selected have the highest rates of behavioral referrals and suspensions for drug and/or alcohol relates problems in the City. SBIRT is a comprehensive, integrated, public health approach to the delivery of early intervention and treatment services for persons with substance use disorders as well as those at risk for developing these disorders. Some underlying principles of SBIRT are (1) Hazardous alcohol and substance use has significant medical, social, and emotional consequences; (2) SBIRT decreases the frequency and severity of drug and alcohol use and reduces the risk of trauma; (3) Earlier intervention leads to reduced costs and less time in hospital; (4) When delivered effectively, SBIRT provides linkages between substance use, mental health, public health, the private healthcare system and healthcare providers; and (5) Brief interventions are effective with a wide variety of behavioral health problems. This initiative is currently funded from our treatment block grant funding.