In the Community and for the Community (ICFC): Boston University Mental Health Training Program for Medically Underserved Communities

Background: The Boston University School of Social Work Off-Campus Program, in collaboration with six Massachusetts community-based mental and behavioral health treatment centers located in medically under-served communities, is implementing the In the Community Mental Health Training for Social Workers Program (ICMH), a work force training program. The objective of implementing ICMH is to increase the number of social work graduates trained in empirically supported assessment and intervention methods for trauma, co-morbid mental health, and addictions disorders in medically underserved communities (MUCs). In Y01-Y02, 14 students representing medically underserved communities received fellowship stipends and were placed in six field agency settings treating clients with co-morbid mental health and substance abuse problems. These students and over 70 field agency clinical staff participated in eight different seminars, which were conducted by four faculty experts on topics such as:  evidence based trauma treatment, cognitive behavioral therapy, IDDT, behavioral health practice in the military, and implementing and adapting trauma interventions with Latino families. Y02 was also expanded to add two 3-credit graduate levels courses for the students only: 1) Clinical Practice and Trauma, and 2) Alcoholism and Drug Abuse: Assessment and Treatment.

Methods: Pre-post test data were collected for all seminars and all graduate level courses from both ICMH students and agency personnel in the following ways:

(1)  At time of enrollment ICMH students were asked to provide information including demographics (age, race/ethnicity, location and number of years of current employment, location (city) and number of years of residence in that city); concurrent employment while enrolled in the OCP/ICMH; employment planned for field placement years (if any)

(2)  Before and after each training seminar, knowledge and SW practice competencies tests were administered to each participant.

Students also completed the consent form prior to participating in ICMH. 

Results: Results from pre and post testing during our Y01 seminars show significant improvements in student and agency staff knowledge across more than number of items. For example, on one measure of identifying appropriate EBPs, 28.6% answered correctly at pretest, and 100% answered correctly at post-test. Similarly, for a question on the lifetime rate of substance use disorders in people with mental illness, 46.2% answered correctly at pre-test and 84.6% of the sample answered correctly at post-test.

Implications: These findings indicate that both students and agency staff have surprisingly low level of knowledge on a range of topics related to co-morbid mental health and substance use disorders. Also, given the changes in health policy in this country and a focus on integration of behavioral health and primary care, workforce training of graduate social workers is key.  The findings point to the importance of providing such work-force training on empirically supported screening, assessment, and treatment methods for co-morbid mental health and substance use disorders.