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Strategies and Adaptations to an Integrated Substance Use and Infant Mental Health Treatment Program During COVID-19

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Abstract

The COVID-19 pandemic resulted in increased parenting stress and substance use. At the same time that mental health and social service needs increased, access to services, including among those receiving treatment, decreased due to stay-at-home orders. Few programs were equipped or prepared to translate their interventions to a virtual format at the start of the pandemic. There is a critical need to identify effective adaptations to substance use and family-focused treatment during the COVID-19 pandemic. Effective program adaptations have continued relevance for the expansion of access to family-focused addiction services beyond the pandemic itself, particularly for rural or other hard to reach populations. Seventy-three semi-structured interviews were conducted with the five agencies participating in the implementation of the In-Home Recovery Program (IHRP), an in-home, substance use disorder (SUD) treatment program. Using a rapid analysis approach two coders analyzed interviews for recurring concepts and themes. Facilitators for adapting services included: (1) the introduction of virtual toxicology screens, (2) helping parents access technology, (3) assisting parents with non-identified children to decrease their stress, and (4) anticipating reoccurrences of substances during the pandemic. Barriers to adapting services included: (1) engaging young children in virtual treatment, (2) privacy, and (3) engaging in telehealth with parents experiencing domestic violence or reoccurrence of substances. Findings reveal virtual substance use treatment is possible. Facilitators to adaptation such as providing access to technology and virtual toxicology screens demonstrate the feasibility and acceptability of utilizing telehealth interventions for substance use. Barriers to adaptations were primarily related to the infant mental health component. Telehealth is likely not appropriate for children below the age of five. Individual sessions focusing on caregiving, rather than dyadic treatment may be more suitable to virtual formats.

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Notes

  1. This foundation provided the initial funding for the IHRP pilot.

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Funding

This study was generously supported through a grant from: New Jersey Department of Children and Families (No grant number).

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Authors and Affiliations

  1. School of Social Work, Rutgers, The State University of New Jersey, 390 George Street, Room 713, New Brunswick, NJ, 08901, USA

    Sarah V. Kautz, Emily A. Bosk, Alicia Mendez & Hannah Pomales

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  1. Sarah V. Kautz
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  2. Emily A. Bosk
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  3. Alicia Mendez
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  4. Hannah Pomales
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Contributions

EAB and AM contributed to the study conception and design. Material preparation, data collection, and analysis were performed by all authors. The first draft of the manuscript was written by SVK and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Sarah V. Kautz.

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Competing interests

The authors have no competing interests to declare that are relevant to the content of this article. The author Emily A. Bosk received the above referenced grant.

Ethics Approval

Approval was obtained from ethics committee of Rutgers University and the New Jersey’s Department of Children and Families Research Review Committee. The procedures used in this study adhere to the tenets of the Declaration of Helsinki.

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Informed consent was obtained from all individual participates included in the study.

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Kautz, S.V., Bosk, E.A., Mendez, A. et al. Strategies and Adaptations to an Integrated Substance Use and Infant Mental Health Treatment Program During COVID-19. Adm Policy Ment Health 51, 17–34 (2024). https://doi.org/10.1007/s10488-023-01300-y

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  • DOI: https://doi.org/10.1007/s10488-023-01300-y

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