Partners With A Role to Play

• CHIP Advisory Council members and organizations
• WNC Healthy Impact
• Buncombe County Emergency Management Services (EMS) – Community Paramedicine and Post-Overdose Response Teams
• Community Harm Reduction providers – community reversals *To be further defined
• Opioid Settlement planning/funding *This is still in planning phase
• Buncombe County Compassion Access Recovery Education (CARE) Team 
• Community-based Crisis Services *This is still in planning phase
• Buncombe County EMS – Community Paramedicine/Post-Overdose Response Team
• Harm Reduction Providers – community reversals *To be further defined
• Community-based peer support specialists *To be further defined
• Sunrise Community for Recovery & Wellness
• Umoja Health, Wellness, and Justice Collaborative
• Appalachian Mountain Community Health Services
• MAHEC
• Institute for Preventive Healthcare & Advocacy

The overall approach used was a modified Results-Based Accountability process. A community input process was facilitated using the RBA Whole
Distance Exercise framework with multiple events held in partnership with community providers to listen to community voices. These input sessions included over 75 individuals including those with lived experience, health care providers, social service agencies, advocacy
organizations and local non-profits. The professionals participating included those working in the health field as well as those
working to address many of the social and economic factors that impact health.

The following actions have been identified by our CHIP Advisory and Leadership Team and community members as ideas for what can work for our community to make a difference on mental health and substance misuse in Buncombe County.

These are actions and approaches that our community partners and Buncombe County residents, including those directly affected by Mental Health and Substance Misuse, say it would take to do better:

These are actions and approaches that our partners think can make a difference:

• Supervised safe-use sites
• Expand access to Medication Assisted Treatment (MAT) 
• Safe, affordable permanent housing
• Engaging youth in community-based organizations
• Refocus housing and food as basic human needs = accessible for all
• Addressing systemic racism with policy and practice standards
• Expand free/lowcost MH services, including Medicaid expansion
• Integrating community health workers into treatment teams
• Policy-wise: increase reimbursement cost for clinicians providing licensed support groups
• Policy-wise: Create open access for private providers to offer services.
• Policy-wise: raise the minimum wage; the cost of living in this area makes it difficult to gain economic independence and stability
• Expand funding for childcare
• Expand insurance coverage for children and reduce co-pays
• Strengthen prevention and early intervention supports that focus on healthy attachment
• More systemic advocacy for policy changes 

What is Currently Working in Our Community 

These are actions and approaches that are currently in place in our community to make a difference on mental health and substance misuse:

• Community Paramedicine & Post-Overdose Response Teams
• Harm Reduction - Syringe Exchange Programs
• WNC Listening Line
• Resources for Resiliency

What Community Members Most Affected by Mental Illness and Substance Misuse Say 

These are the actions and approaches recommended by members of our community who are most affected by mental illness and substance misuse:

• Integrative whole person healthcare - breaking down silos of care
• Destigmatize! Normalize human experiences in response to unhealthy, oppressive, and toxic systems
• Prevention education focusing on the impacts of trauma in and on the body
• Free support services without waitlists - walk-in services that are accessible

Process for Selecting Priority Strategies
Participants in our community input sessions were asked to identify strategies related to the root causes of mental illness and substance misuse in our community. They were provided examples of evidenced-based strategies, as well as prompted to include innnovative ideas and approaches that were no-cost or low-cost approaches. A nominal group dot voting process was used to identify what strategies most resonated across the group. Summary themes and data were shared with the CHIP Leadership team, as well as the CHIP Advisory to make additional recommendations based on feasibility, leverage and impact.

Evidence-Based Strategies 

These are actions and approaches that have been shown to make a difference on mental health and substance misuse:

There are six core principles of Trauma-Informed Care (TIC), as defined by the Substance Abuse and Mental Health Services Administration (SAMHSA), to inform its work with health and behavioral healthcare systems and organizations:

• Safety
• Trustworthiness and Transparency
•  Peer Support
• Collaboration and Mutuality
• Empowerment, Voice and Choice
• Cultural, Historical, and Gender Issues

SAMHSA. (2014). Concept of Trauma and Guidance for a Trauma-Informed Approach, p10. Pub ID#: SMA14-4884.