Evaluation of the Community Mental Health / Alaska Psychiatric Institute Replacement Project
(formerly titled Community Mental Health/API 2000 Project)
In May 1999, the Substance Abuse and Mental Health Services Administration (SAMHSA) awarded federal grant funds to the Alaska Department of Health and Social Services (DHSS) for a 3-year project originally entitled the "Anchorage Comorbidity Services Project," now known as the Community Mental Health/Alaska Psychiatric Institute Replacement Project (CMH/ARP). The project was assigned the task of developing an emergency care system for individuals in the larger Anchorage area with mental-health- and substance-abuse-related crises. The SAMHSA-funded project, later expanded to four years (July 1, 1999 to June 30, 2003), had as its central foci: (1) a 24-hour single point of entry (SPE) into the Anchorage emergency services system to identify appropriate community-based alternatives to hospitalization, provide crisis response services, and streamline placements for consumers in crisis; (2) enhanced crisis respite for stabilization, evaluation, and assessment outside a hospital setting; (3) specialized detoxification services and residential treatment services for consumers experiencing a dual diagnosis of mental and substance use disorders; (4) designated evaluation and treatment beds in secure hospital settings for individuals in crisis and in danger of harming themselves or others; and (5) enhanced extended care with psychiatric back-up as an alternative to long-term hospitalization at API. To augment this comprehensive system of care, a training curriculum was developed that focused on cultural competency, dual diagnosis, and emergency services. Additionally, the possibility of systems and information management systems integration was to be explored.
The State of Alaska contracted with the Alaska Comprehensive and Specialized Evaluation Services (ACSES) branch of the Behavioral Health Research and Services program at University of Alaska Anchorage to conduct a program evaluation of the CMH/API Replacement Project. The evaluation of CMH/ARP had the following goals and objectives:
- To evaluate the process of implementing an optimally integrated, comprehensive system of community-based services for individuals with mental illness and co-occurring substance abuse disorders (including management of multiple funding streams) and to provide of timely feedback for system adjustment and improvement.
- To evaluate the impact of the system changes on client utilization of mental health treatment, substance abuse treatment, and other services.
- To evaluate the outcome of treatment provided for clients in the new system of care.
Sources of evaluation data were: a) archival data routinely collected from consumers by involved mental health and substance abuse treatment agencies; b) interviews with providers and key informants; c) surveys with consumers, providers, agency directors, and other relevant stakeholders; d) historical documents regarding the development of the CMH/ARP plan; e) census data from all affected agencies in the greater Anchorage area; and f) economic data regarding costs of service delivery.
The evaluation of the CMH/ARP project was completed by June 30, 2003. During this time, 88 technical reports were prepared and submitted to the CMH/ARP Policy Team and Management Committee. For FY 2004 (July 1, 2003 to June 30, 2004), the State of Alaska is providing additional funds to continue the census component of the evaluation. Specifically, for the past four years, ACSES has been collecting census data from various community agencies for evaluation purposes. The State has found this data to be extremely useful and wants to continue the census data collection for an additional year.