Using a Racial Equity Initiative to Double Admissions in Family-Focused Recovery

Challenge

Recent research indicates that in New Orleans, a predominantly African American city, approximately 15% of women receiving residential substance use disorder (SUD) treatment are Black/African American (B/AA). This disparity contributes to increased involvement in the child welfare and criminal justice systems and incurs costs for the African American community, the city of New Orleans, and associated parishes.

Solution

Volunteers of America Southeast Louisiana (VOASELA) is developing a Family-Focused Recovery (FFR) inpatient program to address this disparity by successfully recruiting, retaining, and helping to facilitate recovery for B/AA pregnant women and those with children.

Using the evidence-based NIATx Co-Production technique, NIATx consultants worked with VOASELA to co-create a culturally responsive program with the community to align with local culture and needs.

As a significant and important part of this effort, NIATx conducted 14 structured interviews with B/AA women in New Orleans with lived experience. Based on these interviews, NIATx identified the following recommendations for VOASELA to consider as it prepares to open its inpatient FFR program:

Before Residential Admission

  • Continue outreach strategies to recruit B/AA women and children as clients to participate in the residential program.
  • Continuously evaluate the recovery coach-recoveree ratio to identify the ideal number of recoverees that should be assigned to a coach to avoid burnout and compassion fatigue.
  • Initiate the planning process to ensure the program creates comfort for all women in treatment, particularly concerning racial balance.
  • Help increase recovery capital (i.e., internal and external resources) and hope for B/AA women seeking treatment by helping identify goals and purpose in recovery.

During Residential Treatment

  • Foster treatment retention and help women complete the treatment to achieve better outcomes.
  • Become a trauma-informed system of care and create safety for women and girls who have experienced abuse and/or may fear losing custody of children.
  • Provide specialized services for children, including afterschool programming; homework help; sports, drama, and arts; medical, dental and eye exams; mentoring, and parenting classes.
  • Help provide a seamless transition from residential treatment back into the community by creating a Recovery Plan and establishing connections with recovery communities.

After Discharge from Treatment

  • Provide recovery coaching for at least 90 days post-discharge from residential treatment, integrating support in the client’s natural environment and monitoring the effectiveness of both the relapse prevention and recovery plans.
  • Provide family recovery coaching to work with whole families in recovery.
  • Provide continued support to mothers to increase occupational, education, and vocational recovery post-discharge.
  • Continue to be a resources broker, connecting women with needed resources in the community to help support recovery.

NIATx then completed a mapping exercise to integrate these recommendations into clinical and administrative work processes and further help VOASELA address and reduce inequities faced by B/AA women.

Outcomes

During this period, admissions have nearly doubled in VOASELA’s outpatient and peer recovery support programming. In addition, 60% of the program’s admissions are now B/AA, representing a proportional representation within the community.