Gosnold transforming to include treatment for co-occurring disorders

Aug. 11—Gosnold transforming to include treatment for co-occurring disorders

With demand for both substance use care and mental health services spiking during the COVID-19 pandemic, Gosnold Behavioral Health System plans to turn Gosnold at Cataumet into a 33-bed unit for co-occurring disorders and to admit adolescents as young as 16.

Gosnold also plans to shift the mission of Miller House and Emerson House in Falmouth from residences for people in recovery to shorter-term, more intensive rehabilitation facilities.

"We as an organization know that we needed more beds on the acute side," said Richard Curcuru, president and CEO of Gosnold Behavioral Health System.

"Calls have picked up. We are seeing patients who are more acute as a result of COVID," he said.

"During the isolation a lot of people were drinking and using. It's the loss of loved ones. It's the loss of the way life was perceived."

Gosnold at Cataumet currently has 40 beds for substance users and provides detoxification services.

Plans call for renovating the interior to meet hospital-grade standards and installing a total of 33 beds for people with co-occurring disorders, also known as dual diagnosis substance use and mental health disorders.

Curcuru said Gosnold officials are hoping to make the change to a co-occurring disorders clinic by early spring, pending necessary approvals from the town of Bourne.

The renovated and repurposed facility will accommodate 16 and 17-year-old patients, Curcuru said.

Currently, the minimum age for Gosnold at Cataumet patients is 17.

Emerson House for womenand Miller House for men will keep their current number of beds, 37 and 23, respectively but will become co-ed facilities.

Their mission also will change, Curcuru said.

"It will be more of an intensive program" for people needing rehabilitation services, he said.

Currently, people in recovery stay at Emerson and Miller houses for up to 90 days.

Under the rehabilitation model, people will stay at Emerson and Miller houses for three to five weeks before moving onto sober living houses or independent living.

"I don't know when those programs will open," Curcuru said. He said Gosnold is working to make sure it meets any necessary zoning requirements for the project.

Curcuru said the co-occurring disorder beds at Gosnold at Cataumet will provide additional psychiatric services that are sorely needed on Cape Cod.

Patients in need of mental health services are being boarded in emergency departments at hospitals all across the state, Curcuru said.

"There's no availability of inpatient beds."

Treating patients for substance use and mental health disorders simultaneously decreases the potential for recidivism and increases the chances for a successful outcome, Allie Anderson, Gosnold's chief clinical officer said in an email.

"Co-occurring treatment is treating the whole person," Anderson said.

"It is important to get a full picture of someone's emotional and behavioral health issues to ensure we provide the appropriate interventions and treatments needed to address each individual's needs."

"Dual treatment is considered best practices," said Sheryl Kubiak, Ph.D, dean of the Wayne State University School of Social Work in Detroit, MI.

Mental health and substance use issues often interact, and it takes professionals trained in both fields to tease out the differences, she said.

"It's kind of like the chicken and the egg. Which came first?"

"Alcohol is a depressant. Drinking a lot of alcohol can lead to depressive symptoms. Is that a true mental health diagnosis or is that attributable to the alcohol?" Kubiak asked.

"If you treat one without the other, people relapse sooner because the underlying issues haven't been addressed."

Often substance use and mental health counselors are not in communication about a patient, Kubiak said.

A therapist may not realize a client isn't making headway on mental health issues due to heavy drinking, for instance, she said.

Individuals may self medicate to deal with anxiety, depression and other mental health issues, Kubiak said.

"There's underlying issues everyone has, whether it's grief or loss or trauma or abuse as a child. (They) can exacerbate mental health issues but can be covered up by substance use issues."

Kubiak said she works with a lot of traumatized women to help them understand their racing heart and shakiness are part of the trauma.

The knowledge that they were using substances to cope with the lingering effects of trauma "gives them a new power," Kubiak said. "Sometimes when you're working with people around this you can see a lightbulb go on."

In many schools of social work, the substance use course has been an elective, but there is a move now to incorporate education about substance abuse more deeply in the classroom, Kubiak said.

Curcuru said Gosnold plans to hire 60 new staff people, mainly at the co-occurring treatment center at Cataumet.

Kerry Bickford of Marstons Mills, founder of Nathan's Circle, a support group for those who have lost loved ones to addiction, called Gosnold's development of a co-occurring treatment unit "a huge step forward."

"Since at least half of those with substance use disorder have a mental health diagnosis, it is clearly something that needs a lot more focus," she said.

Lowering the treatment age is also beneficial, Bickford said. "The sooner we can help people get a handle on their mental health issues, the greater their chance is at working a solid recovery."

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