The "Story Behind the Curve" helps us understand why the data on the negative affect of substance use on the people of Macon County  is the way that it is. When we understand the root causes of our community problems, we have a better chance of finding the right solutions, together. Those in recovery, local initiatives like No Wrong Door, and a planning group with community stakeholders contributed to the following story data.

What's Helping? These are the positive forces at work in our community and beyond that influence this issue in our community.

• Public recognition of the issue of substance use & engaged community stakeholders
• Support, including: peers, family, and agencies
• Access to care providers in the community, several organizations working on the issue
• Job opportunities for substance users in recovery
• Creative collaboration amongst agencies working on the issue

What's Hurting? These are the negative forces at work in our community and beyond that influence this issue in our community.

• Lack of transportation to jobs, care services, etc. 
• Cost of services
• Stigma attitudes and language affect the how substance users access care.
• Lack of ability to recruit health care professionals to work in the area. 
• Lack of affordable housing for those in recovery
• Perception of agency shortcomings observed by those in recovery
• Unclear of how to get to the youth populataion before they are exposed to risk factors that could influence later substance abuse

Partners in our Community Health Improvement Process: 

• Appalachian Community Services
• Community Representatives and Peer Support Counselors
• County Commissioner
• County Manager
• Macon County Public Health
• Macon County School System
• Macon County Sheriff Office
• Meridian Behavioral Health
• No Wrong Door
• WNC Healthy Impact

Partners with a Role in Helping Our Community Do Better on This Issue: 

• Community Care Clinic
• Full Circle Recovery
• NAMI
• Pharmacies
• Senior Services
• VA
• Vaya Health
• WNCAP

The following actions have been identified by our team and community members as ideas for what can work for our community to make a difference on substance use and mental health.

Actions and Approaches Identified by Our Partners These are actions and approaches that our partners think can make a difference on substance use and mental health.

• Acquirement of "old" hospital.
• Accessible and affordable housing options. 
• Looking into social determinants of health. 
• A place for users to turn in illegal drugs when these individuals want to make a lifestyle change.

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 substance use and mental health.

• Needle Exchange Program.
• Peer Support Specialist or counselors through various partners.
• Crisis Intervention Training through NAMI.
• Medication Drop Off Locations.
• Post Overdose Program through EMS.
• Free clinic through Community Care Clinic.
• Needle disposal boxes through the county and Macon County Public Health.
• Social media campaign through Substance Use Task Force.
• Mental Health Task Force.

Evidence-Based Strategies These are actions and approaches that have been shown to make a difference on substance use and mental health.

What Community Members In Recovery Say These are the actions and approaches recommended by members of our community who participated in a listening session facilitated by Full Circle Recovery on June 6, 2019 and represent those that are most affected by substance use and mental health.

• Conversation about substance use and willingness from others to listen.
• Being in settings where people are still struggling and remembering own experiences with substance use.
• Service work and sharing the message.

Process for Selecting Priority Strategies

Strategies selected were based on various community efforts that address substance use and mental health with the idea that these efforts would have more impact and leverage if they were non-duplicative. This aligns with community values and the continuious work that has been done so far around substance use and mental health. Stratgies for this priority were also selected based on wanting to track the progress of a new program, School Based Health, in the county.