Bristol County Tele-behavioral Care Net (TBH Care Net) program

Mental health and substance abuse are two public health priority areas in Bristol County, Massachusetts. Between 2010 and 2020, opioid overdose deaths per 100,000 population rose nearly 200% in the county (Massachusetts Department of Health, 2021). The rate of poor mental health days reported by Bristol County residents is nearly double the national rate (CDC, 2015).  At the Bristol County Sheriff’s Office (BCSO) correctional facilities many inmates struggle with substance use and mental health disorders. Around 87% of inmate population present with substance use issues and about a third meets criteria for serious mental illness. 

With the purpose of improving health outcomes and mitigating recidivism among inmates with mental health disorders (MHD) or MHD and co-occurring substance use disorders (MHDSUD), BCSO proposes to implement the Telebehavioral Care Net (TBH Care Net) program. The beneficiaries of this program will be adult pre-trial and sentenced inmates at BCSO correctional facilities, who present with MHD/MHSUD. By providing timely and accessible outpatient TBH care for the target population, the program will close treatment gaps and ensure treatment continuity.

TBH services will be delivered using real-time interactive teleconferencing and e-Prescribing, and include psychiatry, medication for opioid use disorder (MOUD), crisis intervention, behavioral counseling, and case management. The proposed program will serve at least 165 unduplicated participants per year.

Project activities include utilizing validated risk and needs screening and assessment instruments; reentry planning; education around telehealth use and technology; coordinating post-release treatment; establishing the TBH Care Team; forming a consumer advisory board; providing TBH care to participants and conducting community outreach. Expected outcomes include increased stakeholder awareness, support of the program, continuity of treatment post-release, reduced high-risk behaviors, data and knowledge sharing among partners, and reduced recidivism.

BCSO, its contracted mental health agency, Correctional Psychiatric Services (CPS) and The Correctional Reentry Clinic (CRC), will work as partners in the proposed program.  The County’s Probation and Parole departments, along with other community agencies, will support efforts by facilitating access to technology and space to conduct TBH sessions.

TBH Care Net will promote racial equity and aim to remove barriers to access to care for historically underserved and marginalized communities including the Black and Hispanic communities in Bristol County.

Program-specific priority areas include using validated assessment tools to identify and prioritize individuals with a moderate or high risk of recidivism and need for treatment. Individuals deemed at high risk of recidivism, will be prioritized for treatment.