Annette Escalante, MSW, MLADC Vice President

Keystone Hall is a non-profit organization that provides comprehensive residential and outpatient substance use disorder treatment, prevention, and recovery supports to New Hampshire community members, including men, women, adolescents and families.

Keystone Hall is a member of the Partnership for Successful Living. A collaboration of six affiliated not-for-profit organizations providing southern New Hampshire’s most vulnerable community members with access to housing, health care, employment and supportive services.

Southern NH HIV/AIDS Task Force

Milford Regional Counseling Services

Welcoming LightHarbor Homes Healthy at HomeKeystone Hall

All programs at Keystone Hall are evidence-based, gender-specific, culturally competent and follow a recovery oriented systems of care model.

Programs

Substance use disorder/dual diagnosis assessments & evaluations

Adolescent Outpatient Program Gender specific intensive outpatient

program Individual and group counseling Impaired driver intervention and aftercare Prevention services Recovery maintenance and aftercare All services available in Spanish No appointments needed

Outpatient Services

Detoxification Transitional Housing Cynthia Day Family Center 90 Treatment for Co-Occurring 28 Day Treatment Program for Co-

Occurring

All clients in the residential communities receive mental health counseling as part of their treatment.

Programs Offered in Residential

Clients stay between 3-5 days Clients come in detoxing from all

substances to include alcohol, opiates, cocaine, marijuana, prescription medication, etc.

Awaiting license for medical detox unit.

Detoxification

Residential Services

Client

28 day TLC

Detox

CDFC90 day

Psychiatry Primary and preventive health care to

anyone over 15 years old Low Income No Income No Insurance With private insurance – Harvard and

Anthem Blue Cross Insured by Medicaid/Medicare Homeless or at Risk of Homelessness

Harbor Care Wellness Center

Why are we here?

Substance Abuse Costs Our Nation More than $484 Billion per Year

The Costs of Drug Abuse are as Substantial as that of other Chronic Conditions:

Diabetes costs society $131.7 billion annually

Cancer costs society $171.6 billion annually

Assessment/evaluation for both substance abuse and mental health

Severity of detoxification Severity of mental health disorder Medication compliance Medication assisted treatment On going psychiatric care Criminal record Family system

Appropriate treatment?

Ov

The Cynthia Day Family Center is funded by the NH DHHS/Division of Community Based Care Services, Bureau of Drug and Alcohol Services.

Pregnant Post Partum Woman & Infants and Parenting Women with Children

The Center is designed to provide a holistic, family centered approach to the treatment of women while allowing them to care for their young children.

Cynthia Day Family Center

For the past 25 years, Cynthia Locke Day has been known as

the lady who wears sparkles in her hair.” Once the Vice

President of IDAK Corp, and a supervisor of 27 medical

facilities, Cynthia’s life became consumed by alcoholism and

her marriage ended in divorce. Within two years, Cynthia was

unemployable. Down to her last $10, she happened to glance

down at the sidewalk and there, in the hardened cement, was

scrawled the message: “Expect a miracle!”

Our dual program offers a unique and comprehensive approach in the treatment of chemical dependency and psychiatric disorders.

recognizes that many of our patients suffer from a variety of psychiatric and psychological problems

Must be over 18 years old. Primary diagnosis must be substance

abuse. Family reunification. NH resident. Pregnant woman get priority.

Overview of CDFC

Substance Abuse Psychiatry Parenting Medical Trauma Domestic violence Life skills Housing Educational/Vocational Financial Legal

Services provided at CDFC

Mental health issues surface after client has been abstinent.

Mental health diagnosis is inaccurate. (Bath slats, meth).

Medical issues during pregnancy. Primary caregiver of children. Children’s issues.

Challenges

Adverse Outcomes

• Numerous health and social problemsrequiring costly care

• Risk for homelessness and incarceration

• Women are at risk of being victims ofsexual abuse and domestic violence

• Parents with co-occurring problems risk

encounters with child welfare

Studies in substance abuse settings have found that from 50% to 75% of consumers had some type of mental disorder

Studies in mental health settings have found that between 20% 50% of their consumers had a co-

occurring substance use disorder

Experts in this field assert that co-occurring disorders should be the expectation, not the exception in any behavioral health care setting

Prevalence of CODs in treatmentSettings

Integrated Treatment

Essential for consumers who are significantly impaired by both kinds of disorder

Essential for consumers whose mental disorder interferes with treatment of their

substance use disorder

Essential for consumers whose substance use disorder

interferes with treatment of their mental disorder

Brain disorders Lack of insight Chronic Impacts family Shame and guilt Require treatment

Common Factors of MentalIllness and Substance Abuse

Why focus on dual disorders?

• Substance use disorders are common in

people with severe mental illness

• Mental illness is common in people with

substance use disorders

• Dual disorders lead to worse outcomes and

higher costs than single disorders

Jaime Gormley LICSW, MLADC

Lindsay Herdman, MSW

Integrated Dual Diagnosis Treatment (IDDT)

Assist persons with both a severe mental illness and a serious substance abuse problem.

Integrated Dual Diagnosis Treatment (IDDT)

Integrated Dual Diagnosis Treatment (IDDT)

Multidisciplinary Team

Integrated Substance Abuse Specialist

Stage-Wise Interventions

Access for IDDT Clients to Comprehensive DD Services

Time-Unlimited Services

Outreach Motivational

Interventions Substance Abuse

Counseling

Integrated Dual Diagnosis Treatment (IDDT)

Group DD Treatment

Family Education and Support on DD

Participation in Alcohol & Drug Self-Help Groups

Pharmacological Treatment

Interventions to Promote Health

Secondary Interventions for Substance Abuse Treatment Non-Responders

High intensity services

Client stories

Questions

PRIZES