Connecticut’s Journey to a Statewide Recovery-Oriented Health-care System: Strategies, Successes, and Challenges

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Part of the Current Clinical Psychiatry book series (CCPSY)

Abstract

Approaches to the treatment of addiction at state level have typically been fragmented, costly, and inefficient. This chapter describes Connecticut’s journey in designing and implementing a transformation of its entire public/private behavioral health-care system, treating 90,000 adults annually, to a recovery-oriented model driven by quality improvement, continuity of care vs. an acute service emphasis, and supported by innovative resource development strategies and service delivery infrastructures. With broad stakeholder collaboration and based on Recovery Core Values created by recovery communities, a Commissioner’s Recovery Policy set the initial tone and direction. The chosen approach addressed interventions for facilitating sustained change at the practitioner/client, program, and overall system levels. The tools for change, such as baseline system assessments, recovery-oriented practice guidelines inclusive of those for co-occurring disorders and gender, trauma and culturally responsive care, all tied to the IOM quality domains, centers of excellence, and state agency linkages with child welfare, criminal justice, and social service systems, are detailed. Critical is a model for innovation, reinvestment, and enhanced outcomes. Different large databases reveal improvements on traditional and new dimensions — 62% decrease in use of acute care and 78% increase in ambulatory care, with 14% lower cost even after adding extensive recovery-support services such as housing and transportation, 40% increase in first time admissions, and 24% decrease in average annual cost per client, especially for high service utilizers. In tough fiscal times, these findings support the value of a recovery-oriented behavioral health-care system and the use of health-care business plans for state systems even more.

Keywords

Addiction recovery management Health-care systems Recovery core values Recovery-oriented system of care 
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Notes

Acknowledgment

This chapter reflects the work of many people who believed in the vision of a recovery-oriented system of care in the late 1990’s and whose skill, creativity and passion helped to bring it to fruition thereafter. Especially noteworthy to the author are the late Jerry Croog, Paul DiLeo, Arthur Evans, Sue Tanner, Sabrina Trocchi, Doreen DelBianco and Irene Williams as well as David Crompton, Wayne Dailey, Steve Fry, Barbara Geller, Julienne Giard, Tom Gugliotti, Dianne Harnad, Karen Kangas, Ken Marcus, Pat Rehmer, Peter Rockholz, Yvette Sangster, Bob Savage, Phil Valentine, and Larry Davidson and his colleagues at the Yale Program for Recovery and Community Health. Many other staff in DMHAS and its private affiliate agencies also paved the way. To all of them a hearty Thank You! Their legacy is improved lives for thousands who learned that recovery is possible and to be expected, and who had the courage to begin the journey into recovery. I will forever be in awe of them and thankful for what they taught me over the last 15 years.

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Copyright information

© Springer Science+Business Media, LLC 2010

Authors and Affiliations

  1. 1.Department of Mental Health and Addiction ServicesCheshireUSA

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