The word “crisis” is used a great deal in reference to the opioid epidemic, but the approach taken by Hartford HealthCare and the Meriden Police Department since 2019 is anything but panicked.
The Meriden Opioid Referral for Recovery (MORR) project is a partnership between the Hartford HealthCare Behavioral Health Network’s treatment facility Rushford, the City of Meriden and Meriden first responders to combat the opioid crisis. A sister program – Meriden Early Diversion, Referral and Retention Project (MERR) – is a similar partnership that includes mental health, domestic violence and veteran’s issues.
Police Sgt. Cary Maikranz has been involved in the partnership since its inception.
“The partnership with police is helpful because, in many cases, officers are trusted in the community and familiar with people in need of help,” he says. “Officers can then respond with a clinician or make a warm handoff to the Rushford team for follow up. It gives the team a degree of credibility and facilitates contact with people they have not otherwise met in person.”
Overdose deaths skyrocket
According to the Connecticut Department of Public Health, in 2021, the most recent year for statistics, 93% of overdose deaths involved an opioid (e.g., fentanyl, heroin or prescription pain reliever). There were 1,531 confirmed deaths for an increase of 11.4% compared to 2020.
In its Drug Overdose Monthly Report, the health department note that, as of the second week of April 2023, there were 326 deaths. Approximately 81.3% involved fentanyl.
MORR directly addresses the opioid crisis through use of Narcan in the field followed by referrals to specialized staff on Rushford’s Crisis Team. They then guide people on their path to recovery.
The program began in 2019, offering treatment for survivors of an opioid overdose, as well as preventative work, community and first responder training, free community access to naloxone, and partnerships with local schools.
Jessica Matyka, clinical director for Rushford’s crisis and acute community programming, says the impetus was rising opioid deaths in Meriden back in 2017.
“Local human services agencies created a workgroup that analyzed the needs of the community, identified where there were gaps in care, and developed an idea for a program,” she explains. “The goal was to provide easy access to Narcan, education for the community, quick and easy access to care and treatment, and partnerships among providers and first responders to be able to provide interventions in real time. We recognized the need for a collaborative community approach, which has proven successful over the last five years.”
Adding MERR to the mix
Noting continued gaps for those with chronic behavioral health conditions, Matyka says MERR was added a year later.
“Through our partnership with the police, we recognized there were calls coming in for police intervention that may be better served through clinical intervention. Through MERR, we provide real-time intervention and follow up for calls that are more behavioral health related. This program allows a team of professionals to provide care and treatment to individuals with chronic conditions, addressing underlying behavioral health needs and reducing calls to 911.”
MORR started with a four-year, $2-million Substance Abuse and Mental Health Services Administration (SAMHSA) grant. That funding ended in September 2022. Since then, the program received $300,000 from the National Association of County and City Health Officials to continue the work.
MERR is funded through a five-year SAMHSA grant.
First Narcan, then treatment
Since MORR’s inception, Narcan has been deployed more than 560 times and 288 of those people were successfully referred to the program. First responders provide information after an overdose and MORR team members connect with the individuals, often while the person is still in the emergency room.
Of the referrals, the team connected with 218, or 76%. Of those, 91% reported they did not have a subsequent overdose as a result.
Three people saved by naloxone and referred to MORR went on to become certified peer support specialists to help others.
They join a team that consists of a clinical manager, case manager, other peer support specialists with lived experience, and a master’s level clinician. The team provides care and treatment in the office, but spends a great deal of time in the community. This innovative approach helps them overcome disparities and access challenges people in the community often face.
Matyka says expansion of the program is in the works.
“Our next step is to hire an embedded clinician in partnership with the police department. The City of Meriden has committed to allocating money in their budget for a full-time police clinician who can respond in real time with officers and provide interventions and follow up for members of the community who may not fit into one of the other grant programs.”
Teaching the community
The program also supports community prevention and training. Meriden first responders were trained in crisis intervention, mental health first aid, Narcan use, and suicide prevention tactics.
In addition, Rushford partners with the Meriden Health and Human Services Department to provide free monthly Narcan education and other classes to the community. Participants who work or live in Meriden receive free naloxone kits after completing the training.
Providing help with experience
Jacky Rodriguez is a Hartford HealthCare recovery support specialist . She worked with MORR for three years and is now part of MERR, working side by side with police to help those with mental health issues.
Diagnosed with ADHD and PTSD and losing her parents at 13, Rodriguez served time in prison in her early 20s. After her release, she found it impossible to find a good job because of her record. A chance meeting when applying for unemployment benefits led her to the RSS certification program. After graduating, she earned bachelor’s and master’s degrees and became a licensed master social worker.
She presented the work she does at the National Mental Health Conference.
“It’s very easy for me to connect with these clients,” she says. “I went through so many of the same challenges. We share some of the same trauma and struggles. I’m so grateful I was able to overcome everything. I can relate to them.”