Q13: Please describe how APRA worked with DMH and other mental health providers in
the District to:
 Improve treatment for co-occurring disorders and to ensure access to appropriate,
quality mental health services for individuals with substance abuse problems;
 Increase the number of persons seen in primary health care settings who receive mental
health and substance abuse screenings and assessments;
 Reduce the suicide rate; and
 Decrease the proportion of homeless adults.
Response: In FY12 APRA continued to work with the Department of Mental Health (DMH) to
strengthen coordination of services for dually diagnosed individuals and streamline access to
substance abuse and mental health systems of care. The Assessment and Referral Center (ARC)
continued to screen individuals seeking substance abuse treatment services for co-occurring
mental illness. Individuals screening positive for indicators of mental health disorders were
referred for care and linkages to mental health providers. Mental health screening is achieved by
using a combination of the District Automated Treatment Accounting (DATA) system’s
Treatment Assignment Protocol (TAP) and the Global Assessment of Individual Needs – Short
Screener (GAIN-SS) assessment tool. In addition, APRA continued to partner with DMH in
supporting the Urgent Care Clinic at the D.C. Superior Court. The Urgent Care Clinic provides
substance abuse and mental health assessments and referrals to service. APRA has also
developed a system to coordinate care for clients that are in substance abuse crisis and
potentially suicidal. Clients that present to the ARC who are suicidal or are in crisis are “fast
tracked” and linked with the Comprehensive Psychiatric Emergency Program (CPEP) onsite for
immediate intervention. APRA also works closely with the Metropolitan Police Department
(MPD) with clients in crisis. The ARC nursing staff has access to officers specially trained to
intervene (onsite) and transport clients in crisis to the appropriate services.
Further, in FY12 DOH and DMH collaborated on important initiatives that have continued in
FY13. First, in FY11 the District was awarded a Minority AIDS Initiative Targeted Capacity
Expansion (MAI-TCE): Integrated Behavioral Health/Primary Care Network Cooperative
Agreement grant. The award is approximately $4 million over three years. The purpose of the
MAI-TCE program is to facilitate the development and expansion of culturally competent and
effective integrated behavioral health and primary care networks, which include HIV services
and medical treatment, within racial and ethnic minority communities in the 12 Metropolitan
Statistical Areas (MSAs) and Metropolitan Divisions (MDs) most impacted by HIV/AIDS. The
expected outcomes for the program include reducing the impact of behavioral health problems,
HIV risk and incidence, and HIV-related health disparities in these areas. This SAMHSA
program’s goal is to ensure that individuals who are at high risk for or have a mental health
and/or substance use disorder and who are most at risk for or are living with HIV/AIDS have
access to and receive appropriate behavioral health services (including prevention and
treatment), HIV/AIDS care and medical treatment in integrated behavioral health and primary
care settings (that may include infectious disease or other HIV specialty providers). This
cooperative agreement complements work that APRA, HAHSTA, and DMH are engaged in to
ensure a “no wrong door” approach to individuals who enter any of the three systems for
services. APRA, HAHSTA, and DMH are collaborating to ensure that regardless of where an
individual enters the treatment system, that individual will be screened for substance use, mental
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health, and HIV needs and appropriately referred for services. Further, APRA and DMH have
been collaborating to develop the framework for co-occurring treatment in the District of
Columbia. The goal of this project is to establish treatment definitions and services to treat
mental health and substance abuse needs simultaneously for individuals who are duallydiagnosed.
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