Examining Integration of Comprehensive Substance Use Services in Certified Community Behavioral Health Clinics: A...

Despite policy efforts to expand integrated behavioral health care in the United States, substantial gaps remain in service delivery for people with co-occurring mental health (MH) and substance use disorders (SUD). Certified Community Behavioral Health Clinics (CCBHCs) are intended to close these gaps through enhanced financing and certification standards that mandate comprehensive, integrated MH-SUD services. Using the 2023 National Survey of Substance Use and Mental Health Services (N-SUMHSS) data for 1,480 facilities (198 CCBHCs, 448 community mental health centers [CMHCs], and 834 other outpatient MH facilities), this study compared service availability across three domains: engagement services, outpatient SUD treatment, and recovery support. Descriptive statistics characterized service provision, and multivariable logistic regressions estimated adjusted odds of service availability by facility type, controlling for ownership, government funding, and being a part of a multisite organization. Relative to other outpatient MH facilities, CCBHCs had significantly higher odds of providing engagement services, including interim services, outreach, and transportation, as well as outpatient SUD services, including outpatient detoxification and medication-assisted treatment. CCBHCs also exhibited greater availability of recovery-oriented support, including employment counseling, assistance obtaining social services, and housing supports. These findings provide some of the first national evidence that the CCBHC model is associated with substantially broader SUD-related service offerings than traditional CMHCs and other outpatient MH settings. By expanding both clinical SUD care and enabling services that reduce access barriers and address social determinants, CCBHCs appear well positioned to improve care continuity and recovery for individuals with co-occurring MH and SUD conditions.