Fraudulent Student from from Deerfield Beach, Florida

Paper Subject: Social/Community Change Proposal

Class: SOW4343

He ordered a sample research paper on April 2006 (attached below). He did an unauthorized chargeback (he claimed has never contacted us and hasn't received any paper from us).

Obviously he lied - in one of the emails he even confirmed and thanked us for an excellent paper. Merchants beware.

Kenneth, USA

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Group Home for Dual Diagnosis Substance Abusers

I. INTRODUCTION

The program involves the development of a group home located in Manchester NH for individuals that are diagnosed as substance abusers with an accompanying mental illness, which is commonly referred to as a dual diagnosis. The program is intended to provide the participants with the skills necessary to manage their substance abuse and mental health issues in a supervised environment, with the ultimate objective of fully returning the individuals to the community. The program is intended to remedy the community problem of individuals with a dual diagnosis that are addicted to alcohol or narcotics and have difficulty managing their mental illness as a result of the addiction.

The community will benefit from the program by reducing the number of individuals that are marginalized as a result of addiction coupled with mental illness, allowing them to return to a productive status. The specific goal of the program is to establish a group home that can support 15 residents, with the 18 months as the anticipated average duration of their stay under supervised care. The program also involves the use of various types of support services for the residents developed in conjunction with local mental health and substance abuse programs. While there are substantial initial costs to establish the program, the long term costs are reduced by contributions from the residents of the facility and the reduction in expenditures for police and social services by the community.

II. PROBLEM IDENTIFICATION

The number of individuals that suffer from both substance abuse and mental disorders in the United States is estimated at 10 million (Mojtabi, 2004). Approximately 50% of the individuals that have a sever brain disorder also have a substance abuse problem. The two disorders are interrelated in that the substance abuse inhibits the individual from obtaining adequate treatment for the mental disorder while the mental disorder contributes to the substance abuse. With some types of mental disorders such as schizophrenia, the substance abuse is the outcome of self-medication in an attempt to alleviate some of the symptoms of the disorder. Individuals with dual diagnosis are more vulnerable than the general population for employment and housing instability, and criminal victimization. In addition, they have a higher incidence of HIV and Hepatitis infection. In addition, approximately 50% of the individuals with a dual diagnosis have contact with the criminal justice system at some point in their life (Calsyn et al, 2005).

The traditional approach to the treatment of a dual diagnosis patient has been to treat the disorders as separate, with the substance abuse treatment not linked to the treatment of the mental disorder. A national survey regarding the treatment of dual diagnosis patients found that 37.8% of the substance abuse treatment facilities did not offer psychiatric services and 43.4% of the facilities did not offer prescription drug services to their patients. In addition, 26.7% of the facilities did not have case managers to coordinate services to patients (Mojtabi, 2004). Because of the special requirements of individuals with a dual diagnosis for psychiatric services, the approach involving the separate treatment of the disorder has not proved effective in reducing substance abuse in this population.

The target community of Manchester NH currently does not have any established program to deal with individuals with dual diagnosis. The community has a population of 120,000. Based on the national statistics indicating that 11 million or approximately 4% of the population are dual diagnosis, the program has a target population of 4,800 individuals. Because many of these individuals receive services from family members and other community agencies, the number of individuals that are eligible for services in the proposed program is estimated at 200. At the current time, the number of homeless individuals in the community is increasing, with many of these individuals suffering from a dual diagnosis. In addition, there is an increase in the number of arrests among individuals that have been subsequently identified as suffering from a dual diagnosis, with criminal activity motivated by the need to acquire funds to support the substance abuse.

Implementation of the proposed program will benefit the community by reducing the number of individuals that are socially and economically marginalized as a result of their disorders. In addition, it will reduce the costs to the community for financial and other type of assistance to these individuals over the long term by enabling them to reintegrate into the community.

III. PROGRAM DESCRIPTION

The program will operate through the use of the group home concept in which dual diagnosis patients are placed in a supervised environment where they receive assistance with managing both their substance abuse problem and mental disorder. Eligibility for residency in the group home is based on the dual diagnosis, with the individuals free from the abuse of additive substances for a period of 30 days prior to admission to the group home. This requirement that the prospective resident be free of substance abuse for an extended period prior to admission is based on the continuum of care model in which the group home services focus on the long-term rehabilitation of the resident (Tsemberis, Gulcur & Nakae, 2004). The determination for eligibility will be made by the program staff based on the recommendations of the community mental health and substance abuse treatment facilities.

Continuation in the program for residents is contingent on their remaining free from substance abuse and compliance with the medication regime prescribed by the mental health professionals providing treatment to the residents.

The program content will have a primary focus on the development of strategies for the residents to manage their substance abuse problem, with ongoing substance abuse therapy a mandatory component. In addition, the program will emphasize the development of life skills such as vocational training and the skills necessary to allow the residents to become economically self-sufficient. It is anticipated that the majority of the residents will be receiving disability benefits, but will nonetheless be able to obtain part-time employment. Additional assistance will be provided to the residents in money management to enhance their ability to function economically after they leave the program. In this operating model, the program will integrate substance abuse treatment, mental health therapy and vocational education, which has been shown to be an effective method of rehabilitating individuals with a dual diagnosis and reintegrating them into the community (Becker, Drake & Noughton, 2005).

The group home residential facility will be staffed on a 24-hour basis by trained substance abuse counselors. The role of the counselors is to supervise the behaviors of the residents and to provide guidance to assist the residents in developing life management skills. Psychiatric services will be provided on an out patient basis by the local mental health community service facility. Vocational services and employment counseling will be provided by community agencies that specialize in this type of training and assistance. The duration of the stay of the residents in the program will be determined by their rate of progress in remaining free from substance abuse and in developing the skills necessary to become self-sufficient in the community. The maximum length of stay for any resident will be 18 months, although it is anticipated that the average length of stay will be 12 months. Because of the large number of individuals in the community that require services and the relatively limited resources of the program, residents that have been discharged from the program will not be eligible for readmission. Participation in the program is completely voluntary, with residents able to self-discharge at any time subject to the caveat that they will not be eligible for readmission.

The program will be effective in reducing the number of dual diagnosis individuals that produce the greatest burden on community resources. The program will have an impact on the homeless and indigent population in the community by identifying some individuals that can eventually become self-sufficient. The program will also reduce the amount of resources that the community devotes to providing services for the target population over the long run. Studies indicate that individuals with a dual diagnosis that receive treatment in a continuum of care model that includes components similar to those incorporated into this program have a significantly lower rate of substance abuse recidivism than similarly situated individuals that do not receive the same level of care (Tsemberis, Gulcur & Nakae, 2004).

IV. GOALS

The group home program for dual diagnosis individuals has the following goals:

1. To develop a residential treatment facility based on the group home model for 15 individuals in the community with a dual diagnosis, with a maximum duration of treatment of 18 months

2. To provide effective rehabilitation treatment for a vulnerable segment of the community that suffers from a specific combination of disorders

3. To reduce the amount of resources that the community devotes to the problems created by

individuals with a dual diagnosis, including homelessness, crime, and financial assistance.

4. To reduce the substance abuse problem in the community

5. To enable members of the target population to become self-sufficient
The program will accomplish these goals through the use of a multi-faceted treatment model in which

residents in the group home receive training in support to assist them in managing their mental disorder and substance abuse problems. In addition, the program will use measurable criteria to insure that the individuals selected for the program are the most likely to succeed over the long run, insuring that the community derives a benefit from the resources that are expended on the program. The program will also use the available resources from other agencies that provide psychiatric, substance abuse and vocational services as a means of insuring that the goals are met.

V. MACRO REALITY

The personal strengths with the program are experience with the operation of a dual diagnosis group home and an understanding of the methods that are used to encourage individuals with a dual diagnosis to improve the management of their disorder. In addition, there is an ability to liaison with other community agencies to support the development of an integrated rehabilitation plan. The personal weakness with the program is insufficient understanding of the financial and operational management of a group home. This weakness can be remedied through employing staff members with the necessary skills.

The current situation involves the lack of adequate treatment facilities for dual diagnosis individuals, with an increase in the homeless population, crime rate and utilization of social services likely to occur if no action is taken. The forces supporting change are the desire of the public for less crime and homelessness; the need for the city government to expend less resources on crime control and social services; the desire of various community groups such as religious organizations to provide adequate care for the mentally ill; the availability of grants and subsidies from various state and federal sources for substance abuse programs; and the willingness of individuals with dual diagnosis to seek treatment for their disorders. The strongest of these forces supporting change is the desire of the public for less crime and homelessness and the need for the city government to reduce its expenditures on crime control and social services. The forces opposing change is the short-term focus of the city budgetary process that does not easily accommodate long-term capital expenditures; the unwillingness of residents to accept a dual diagnosis group home in their neighborhood; and the limited budgets of other social services agencies that hamper the expansion of their services to include the specific needs of a dual diagnosis population. The strongest of these forces opposing the program is the short-term focus of the city budgetary process, which seeks to produce measurable results from a program in a relatively brief period of time. To create additional support for the project and move it away from equilibrium, it will be necessary to increase the level of support from the general public and community groups, thereby placing pressure on the city government to reduce its emphasis on short-term results from budgetary allocations.

VI. PEOPLE OF INFLUENCE

The individuals with the greatest degree of influence over the project are the major of the city, the director of state mental health services, and a local therapist that has been a strong advocate for services for individuals with substance abuse problems in the community. The mayor of the city has been recently elected on a platform of reducing crime and improving community services. The crime rate in the city escalated under the previous administration, which reduced funding for police and community service programs. Demographic shifts over the past decade have also increased the population of the city, with a larger group of individuals with substance abuse problems now residing in the community. The mayor is currently evaluating a number of community services programs and considers programs to mitigate substance abuse a high priority for his administration. The director of the state mental health services also has some influence over the project, with the state recognizing that there are inadequate facilities for the treatment of individuals with a dual diagnosis within the community. The state has indicated its willingness to participate in the development of a program that can treat individuals with a dual diagnosis and will provide support for a community initiative. A local therapist in the community that is employed by the state has also been a strong advocate for programs to mitigate substance abuse. This advocacy has primary focused on an educational effort in the community to demonstrate that effective substance abuse problems can contribute to the mitigation of various community problems such as crime and homelessness. The therapist has elicited support for substance abuse programs from various civic and religious groups in the community.

VI. POTENTIAL COSTS AND BENEFITS

The costs for the project involve an initial amount to establish a group home and ongoing operational costs. The initial funding for the project will be derived from community, state and federal sources based on the existence of various types of matching funds programs to assist communities with developing services for mental health and substance abuse programs. The operational costs for the project will be funded partially from the city budget, contributions from the residents of the facility, and grants from various federal, state and private agencies.

The initial cost for the development of the group home facility is estimated at $75,000. This estimate is based on the assumption that the city can use a building for the project that it already owns as a result of tax forfeiture. The cost estimate is for the renovation of the building to make it suitable for residential treatment. It includes an estimate for office supplies including a basic information technology system. Because of the availability of grants from various sources for the development of community substance abuse programs, the actual cost to the city for the renovation of the building may be less than the estimate.

The estimated annual operational budget for the project is as follows:

Cost of Operation

Salaries 155,000
Benefits 23,250
Food 18,250
Utilities 7,200
Maintenance 6,000
Transportation 6,000
Insurance 9,000
Total 224,700
Resident Contribution 90,000
Grants & Contributions 20,000
Required Budgeted Amount 114,700

The salary component of the budget is based on the assumption that the facility will require a director at a salary of $35,000 a year and 4 counselors at $25,000 a year. The program operation requires the continuous presence of at least one counselor at all times, with 4.2 counselors required for full weekly coverage. In the anticipated operational model, the director will provide coverage for vacation and sick time of the counselors. The benefits for program staff are based on 15% of the base salary of the employee. Because the group home is a residential treatment facility, it includes food service, which is estimated at $50 per day. The transportation component of the operating costs is due to the need to provide some type of transportation services for the residents to obtain medical services and to meet employment obligations. Individuals with a dual diagnosis often do not have a driver's license and cannot afford private transportation. In addition, the public transportation system in the community does not operate on Sundays and holidays, making it difficult for residents to meet employment obligations on these days without an alternative form of transportation.

The contributions of residents towards operations are based on the assumption that all residents will contribute $500 per month towards room and board. Individuals with a dual diagnosis are generally eligible for social security disability benefits, which provide them with an income that is sufficient to cover their room and board. Because the program encourages residents to obtain part-time employment in the community, they also have the opportunity to supplement their social security income. The budget also assumes that the program will be able to access grants and contributions to support its operations on an ongoing basis.

The benefits from the program are both quantifiable and intangible. The cost benefits involve the reduction in expenditures by the community for crime control and social services for the target

population. These cost benefits are estimated as follows:
Reduction in Crime Costs 30,000
Reduction in Social Services Costs 45,000
Increase in Tax Revenue 4,500
Total 79,500

The reduction in crime control costs are based on the cost to the community by criminal activity among substance abusers including police costs and the losses sustained to the community from criminal activity. The reduction in social services costs is based on the assumption that the program will increase the self-sufficiency of participants, reducing the community burden of providing services. The increase in tax revenue is based on the assumption that the residents of the facility will obtain employment and become productive members of the community during their treatment period and after their discharge. The intangible benefits of the program cannot be financially quantified and include the general improvement in the quality of life in the community, which operates as an incentive for community growth and development.

VIII. PROFESSIONAL AND PERSONAL RISK

The professional risk in establishing the group home program for individuals with dual diagnosis is that the program will not achieve its goals. The rehabilitation process is complex and involves a large number of personal and institutional variables. Some of these variables are adequate funding, effective liaison for services with other agencies, the selection process for residents, and the adequacy of follow-up care following discharge to inhibit recidivism. As a result, the success of the program is contingent on its ability to manage these variables in a manner that maximizes the possibility of long-term rehabilitation among the residents. In addition, there is some disagreement among researchers that the proposed integrated treatment model is more effective than the separate treatment model with dual diagnosis individuals, increasing the level of risk (Brooks & Penn, 2003).

The personal risks associated with creating the program involve the future ability to influence the decision-making process in the community in the event that the group home treatment facility for dual diagnosis individuals is not successful. Implementation of this program requires the expenditure of a significant amount of political capital in the community due to the need to persuade various decision makers that the program concept is viable. The failure of the program to achieve its goals would reduce personal credibility and restrict opportunities for the development of future projects that could benefit the community.

IX. PROGRAM PROMOTION

The program would be promoted only among the mental health and substance abuse professionals in the community, with information disseminated through personal contact with the decision makers. The program will prepare an information sheet outlining its goals, criteria for selection and the procedure for entry into the program. The program will not directly solicit participants from the community, but rather will accept residents in the group home following referral from mental health and substance abuse professionals. There are a relatively small number of individuals in these professions in the community, which supports the use of this type of promotional method. The promotional strategy is based on the criteria established for acceptance of residents in the program, which requires a clearly defined dual diagnosis and the absence of substance abuse for a 30-day period prior to acceptance. In addition, the promotional strategy is based on the assumption that there may be neighborhood objections to the presence of a group home if there is extensive publicity surrounding the operation of the facility.

X. EVALUATION OF THE POTENTIAL SUCCESS OF THE MACRO CHANGE

There are a large number of advantages to the proposed program of a group home for the treatment of individuals with a dual diagnosis. The community can provide direct assistance to a vulnerable segment of the population that contributes to the community problems of homelessness, crime, and substance abuse. The individuals receiving treatment can potentially become more productive members of the community, contributing to its economic and social life. The program can enhance the community image by demonstrating its commitment to providing services to disadvantaged segments of the population. If the program proves successful, it can also be expanded to incorporate a larger number of individuals in need of treatment. A significant disadvantage of the program is that it is not revenue neutral and requires an ongoing financial commitment from the community. Another disadvantage to the program is that it is not likely to result in complete success among the residents, with a percentage of recidivism occurring despite the effort at intervention. Based on the assessment of advantages and disadvantages to the program, it should be implemented. The potential for improvement in the quality of life in the community outweighs the risk that the program will fail to meet its intended goals.

XI. PROGRAM EVALUATION

The effectiveness of the program can be evaluated through the use of quantitative measures. The primary measure is the recidivism rate among residents and individuals that have completed the residential treatment program. While it is anticipated that there will be some recidivism among residents, the level should be less than the general recidivism rate among individuals with a dual diagnosis that have completed drug rehabilitation but have not resided in a group home setting.

Because the program has the specific goal of integrating residents back into the community after a maximum treatment period of 18 months, an additional measure can be established based on the percentage of residents that achieve this goal. Data regarding the effectiveness of specific treatment methods used in the program can be obtained through the use of a survey questionnaire disseminated among the residents. The questions on this type of instrument ill focus on the perceived effectiveness of various activities such as daily substance abuse support meetings, staff assistance with financial management, and vocational and employment training. Additional data regarding the perceived effectiveness of the program can be obtained from surveys of the mental health and substance abuse professionals in the community.

XII. CONCLUSION

The program to develop a group home for individuals with a dual diagnosis can make a significant contribution to the quality of life in the community by reducing substance abuse, crime and homelessness. The use of a facility that is specifically designed for the needs of individuals with a dual diagnosis increases the likelihood that the individuals will be fully rehabilitated and reintegrated into mainstream community life. Implementation of the project requires obtaining the support of the mayor, mental health and social service professionals in the community. Although the project involves an ongoing commitment from the city budget, the benefits to the community over the long term are significant. In addition, the effectiveness of the program can be demonstrated by quantifiable measures.

References

Becker, D.R., Drake, R.E. & Noughton, W.J. (2005).Supported employment for people
with co-occurring disorders. Psychiatric Rehabilitation Journal, 28(4), 332-338.

Brooks, A. & Penn, P. (2003). Comparing treatments for dual diagnosis: Twelve-step and self-management and recovery training. American Journal of Drug and Alcohol Abuse, 29(2), 359-383.

Calsyn, R.J., Yonker, R.D., Lemming, M.R., Morse, G.A. & Klinkenberg, W.D. (2005).
Impact of assertive community treatment and client characteristics on criminal justice outcomes in dual diagnosis homeless individuals. Criminal Behavior & Mental Health, 15(4), 236-248.

Mojtabi, R. (2004). Which substance abuse treatment facilities offer dual diagnosis
programs? American Journal of Drug & Alcohol Abuse, 30(3), 525-536.

Tsemberis, S., Gulcur, L. & Nakae, M. (2004). Housing first, consumer choice and harm reduction for homeless individuals with dual diagnosis. American Journal of Public Health, 94(4), 651-656.