4 . Theme / Strategic Objective 4 : Breaking Down Silos
All other research “ themes ” and related behavioral health ( including SUD ) needs and service gaps can be positively impacted by effectively breaking down communication and operational silos .
Throughout the qualitative research , the air of collegiality permeated conversations , yet many participants feel that silos still exist – negatively impacting the quality of care and the efficiency with which care is provided . Respondents suggest that competing financial interests and laws that hamper the ability to share patients ’ protected healthcare information are among the contributing factors .
Another point of conversation within the theme of Breaking Down Silos is the belief that the criminal justice system plays an important role in both addressing and treating behavioral health and substance misuse . In fact , some stated that the criminal justice system may be one of the largest suppliers of mental health services in Polk County . Some interviewed feel that this is a consequence of a fractured healthcare system , and opine that by breaking down silos , improving communications among providers , and improving communications between providers and the various public safety entities , the number of people in jail or prison experiencing behavioral health and substance misuse would decrease . They suggest that breaking down silos would help ensure that people who need help can find the right type of care , rather than being criminalized , generating extreme societal benefit .
There is evidence that initiatives are already growing to address this issue in Polk County . One example is behavioral health providers holding office hours at primary care facilities ( i . e ., co-location of providers ). Another example is mental health counselors being available to 9-1-1 personnel both telephonically and for inperson mobile crisis care , as previously noted . Both illustrate creative problem-solving initiatives among community organizations . To quote one participant , “ Polk County seems ahead of the curve for working together and problem solving .” Several research participants also strongly suggested that expansion of mobile crisis care services across community-wide organizations could further help break down silos .
Silos impact the continuity of care , as noted . A recent Florida-based study of opioid use disorder ( OUD ) patients shows that 72 % of people identified with OUD never receive medication to address the issues ; people who do not continue with a six month medication treatment regimen are five time more likely to die from OUD-related events . 43 Research participants indicate that breakdown silos and having additional supports in place will greatly improve outcomes . See “ Cascade of Care ” appendix .
For this report , we narrowed the action areas for this theme to :
• Increasing focus on public safety and jail-related issues , including community transitions
• Collaboration and communications
Both are covered in detail below .
43
Johnson , K ., Hills , H ., Ma , J ., Brown , C . H ., & McGovern , M . ( 2020 ).
Treatment for opioid use disorder in the Florida Medicaid population : Using a cascade of care model to evaluate quality . The American Journal of Drug and Alcohol Abuse , [ Epub ahead of print ]. doi : 10.1080 / 00952990.2020.1824236
57