Data Collection From 11/5/2018 - 4/1/2020

RESULTS

44 participants engaged 90+ days who made significant reductions in substance use

  • 101 ED visits and 55 hospitalizations 6 months prior to program

    • Nearly all healthcare visits were substance use related

      • Interesting fact: of these 44 participants, 7 were referred from ED, 24 were from medical units, 10 from mental health units, and 3 from detox.

  • 39 ED visits and 14 hospitalizationssince engaging in program

    • 61% reduction in ED visits and 75% reduction in hospitalizations

    • 90+% reduction in substance use related ED visits and hospitalizations

      • Nearly all healthcare visits were not substance use related

  • There are 5 participants whose data is not included above. These individuals have significant medical conditions that require high utilization of hospital services. For these individuals it is difficult to calculate and convey impacts of sobriety and returns to use with healthcare utilization. 

Participants engaged 90+ days who did not make significant reductions in substance use: 11

  • No reduction in ED visits or Hospitalizations​

Referral Data as of 4/1/2020

  • Total Referrals: 828

  • Current active participants: 47

  • Participants meaningfully served 30+ days: 95 (approximate)

  • Referrals with 0-1 contacts: 533

  • Referrals with 2-5 contacts: 165 (approximate)

  • Participants served 90+ days who completed program: 18

  • Referrals who have been referred more than once: 45

  • Mobile Rule 25 Assessments completed: 108

    • Individuals placed to treatment: 62 of 108​

    • Individuals completed treatment: 39 of 62 

    • Unknown if individual completed treatment: 7 of 62

  • Referrals residing in Ramsey County: 509

  • Referrals residing in Dakota County: 143

  • Referrals residing in Washington County: 139

  • Referrals residing in "other" county: 33

  • Referrals from St. Joseph's Hospital: 247

    • ED: 97

    • Medical: 103

    • Mental Health: 29

    • CD Unit: 18

  • Referrals from Regions Hospital: 229

    • ED: 111

    • Mental Health: 59

    • Medical Units: 59

  • Referrals from St. John's Hospital: 140

    • Medical: 134

    • ED: 6

  • Referrals from Woodwinds Hospital: 72

    • Medical: 68

    • ED: 4

  • Referrals from United Hospital: 32

    • ED: 24

    • Medical: 8

  • Referrals from Ridges Hospital: 39

    • ED: 11

    • Medical: 28

  • Referrals from Lakeview Hospital: 6​ (Medical)

  • Referrals from Regina Hospital: 16 (Medical)

  • Referrals from Ramsey Detox: 14

  • Incomplete referrals (OTHER): 22

Lessons Learned in 2019

1. Age is significant factor for long-term engagement in program or perhaps in other words, "readiness for change". Of individuals who remained engaged since referral, average age was 46. There were only a select few individuals in ages 20's & 30's engaged long-term. 

  • Due to age and physical or mental health disabilities, Medicare insurance was a significant barrier in finding residential treatment, mental health therapy providers, and psychiatry providers. 

2. Education, housing, and level of supports are significant protective factors for long-term engagement. Individuals with permanent housing, with significant other/close family, more education and work experience had much more involvement and comprehension of services.

3. Due to 388 of 616 referrals having just 0-1 contact since referral, it was surprising the amount of individuals who did not respond to initial contact attempt. It is assumed they either had a very short window of opportunity to consider change, or did not have genuine intentions of following through with program. Therefore, they could have signed consent form to satisfy hospital staff or family encouraging participation in program.

4. Most referrals appeared to have aspirations of attempting sobriety, but appeared to be under the impression they could "think themselves out of addiction" with minimal lifestyle changes. In other words, referrals lacked understanding and appreciation of making a conscious effort to change lifestyle through investing in treatment, sober support meetings, sponsorship, metal health therapy, etc. 

  • For example, individuals on the referral sheet who checked interest in outpatient or "maybe" treatment had very low initial or long-term engagement in program compared to individuals who checked residential treatment.

5. For individuals receiving social security income and residing in income-based housing, it was particularly challenging to motivate them to reduce isolation and have interest in resources and treatment providers. 

Goals for 2020

1. Increase percentage of in person contact with referrals on medical units. Ideally, referral sources send referrals earlier in medical stay, creating more room for Mobile SUDS Team to make contact bedside. In addition, it would be beneficial for ED providers who meet with individuals who are admitting to medical unit, to make the referral anyways and note that they are admitting to medical unit. 

  • In 2019, we noticed significantly more engagement with individuals referred by medical units. They appeared to typically have higher protective factors including housing, supportive family or friends, education, employment experience, medical necessity for sobriety and willingness for residential treatment. 

  • We are considering options of trying to find better processes to being more active and present on medical units.

2. In 2019, the team averaged approx 50 referrals per month. There was significant variation between winter and summer months. Summer months averaged around 40/month and winter months 60/month. There also was less long-term engagement and willingness for services during summer months. We would like to average 60 referrals per month for 2020 and find ways to balance out summer and winter month referrals. 

3. Increase involvement in social activities and offered by team and engagement within sober support community. 

4. Increase engagement with family or friend supports of participants. Possibly offer an al-anon meeting or opportunities for family/friends to meet with counselors on team.

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