Alaska is using its Strategic Prevention Framework State Incentive Grant (SPF SIG), a five-year infrastructure grant from SAMHSA, to address the impact of substance abuse on related behavioral health problems, including intimate partner violence and suicide.
Over the past decade, Alaska has worked diligently to address substance abuse and other behavioral health problems in a systematic and coordinated way. In 2003, Alaska’s Department of Health and Social Services established a Division of Behavioral Health, which brought together the disciplines of substance abuse and mental health. With its SPF SIG, Alaska is deepening its commitment toward better integration of its behavioral health programming.
SAMHSA’s SPF SIG is designed to help States, Tribes, and Jurisdictions build a foundation for delivering and sustaining effective substance abuse and/or mental health services. As a first step in this process, grantees are expected to establish a multidisciplinary epidemiological workgroup, charged with examining data about the nature and distribution of substance use and related consequences in the State.
When Alaska’s epidemiological workgroup began examining the State’s substance abuse data, two problem areas immediately rose to the top: youth alcohol use, and heavy and binge drinking among adults. So, too, did a variety of consequences of these drinking behaviors. Among these was intentional injuries—domestic violence, interpersonal violence, sexual assault, and suicide/self-harm.
Consistent with its commitment to applying a behavioral health lens to its prevention work, Alaska decided to prioritize intentional injuries as the focus of its prevention efforts. Over the course of the grant, the State will monitor rates of intentional injuries to determine if successfully reducing the two prioritized consumption patterns—underage drinking and heavy and binge drinking among adults—leads to a reduction in these related behavioral health conditions.
The process of selecting these priority consequences was a “journey,” according to Diane Casto, project director for the SPF SIG and manager for prevention and early intervention services with the Alaska Division of Behavioral Health. “Everyone at the table had their own priorities and their own area that they saw as most important . . . Ultimately, looking at the way that people are injured by their alcohol use was really what drove us.”
Casto understands, however, that the success of State efforts to reduce intentional injury relies on the ongoing involvement of multiple players working across disciplines, including community and tribal health organizations, law enforcement, shelter providers, child protection, department of transportation, and public health.
Casto says it’s easier in Alaska to bring people together, even with the large geographic areas that separate them, because the community of practitioners is small and everyone knows each other. Yet despite that familiarity, they don’t always agree on terminology or approach. “Getting everyone talking about the same thing, and focusing on the same issues, the same consumption patterns, the same consequences, looking at the data the same way, is critical,” she says.
SAMHSA’s Center for the Application of Prevention Technologies has been instrumental in helping participants bridge these language and conceptual divides, Casto says. “The CAPT is assisting us in taking the documents that our workgroups have developed and making sure we’re using a common language. That is how we’re going to be able to start making a change.”