Social Work Training Tackles the Opioid Abuse Epidemic With Integrated Care

For years, the University of Pittsburgh's School of Social Work has sent master's level students into community settings, counseling people with substance use disorders and helping them untangle the sometimes-complex web of social services available to them.

But for Pitt Professor of Social Work Daniel Rosen, it wasn’t enough. He was noticing the sharp uptick in the number of fatal opioid overdoses in this region. The 2017 Allegheny County rate of 60 deaths per 100,000 people was triple the national average. And, according to Open Data PA, nearly one in five overdose deaths in the last decade had involved someone 55 years of age or older.

“It became clear to me that people in need of treatment and supports were not receiving them,” said Rosen, who has spent decades researching the problems related to substance abuse for different populations. “The region’s traditional support systems, ranging from ambulatory services to hospitals to substance abuse treatment centers, were being overrun by the sheer number of individuals and the complexity of their problems.”

Rosen and his colleagues have secured a $1.25 million federal grant to not only strengthen opioid abuse training for 70 master of social work students, but to put them in some of Allegheny and Beaver County’s highest areas of overdose deaths and also to train the staff manning the School of Social Work’s community partner organizations.

The Opioid Workforce Expansion: Social Work Initiative for Program Professionals is a new three-year project funded through the Health Resources and Services Administration. Each year the initiative will recruit a broad and diverse cohort of students from three of the school’s certificate programs—integrated healthcare, gerontology and mental health. Through an advanced curriculum, six annual seminars and specialized field placements at sites in critical areas, these students will develop skills to work in interprofessional settings and to better understand the relationship between the physical and behavioral health issues of people with opioid use disorders.

The initiative doesn’t stop there. It will provide additional training for all Pitt social work faculty as well as for the people working at those neighborhood sites. They’ll be able to take School of Social Work continuing education courses at a reduced rate or free of charge.

“This project will make the students more efficient and our agencies more effective,” said Rosen.

At the heart of the initiative is integrated care, which is helping to break down the silos of drug addiction, mental health and physical health.

“We’ve seen the transformation of the role of the social worker in the health care system,” he said. “A doctor may come in and see a patient complaining of back pain, prescribe an MRI, and leave. Now a social worker is present who can help coordinate all the patient resources. Does he have a way to the clinic? Does he need help navigating through the system? Does he have access to food? It is empathetic care coordination and it makes all the difference.”

The Squirrel Hill Health Center in Pittsburgh was an early partner with the School of Social Work and will help train masters of social work  students in this new Opioid Workforce Expansion program. CEO Susan Kalson said her center was one of the first to adopt the integrated care model.

“Our patients are healthier when they get their care in one place,” she said. “The triad of doctor, social worker and patient—they can all work together on the best plan for that patient’s care. You can’t treat the mind and body separately. They’re not separate.”

By putting the social work students in with other team members, be they doctors, nurses or pharmacists, they all learn one another’s languages and how best to interact with one another. Pitt’s School of Social Work and UPMC have already built that concept into the school’s Roth Fellowship and Edith M. Baker Integrated Care Fellowship.

“We are committed to training the next generation of social workers,” said Kalson. “And we want to hire people who understand this integrated model.”

“Social workers have historically stepped into situations to improve the coordination of care for an individual with a substance use disorder,” said Rosen. “This grant will allow us to build an infrastructure that will last for years.”