The Arukah Institute of Healing operates under the mission of bringing accessible, relational, and innovative behavioral healthcare to rural communities in central Illinois, which are federally underserved and have a large portion of residents who are underinsured or uninsured. Arukah was founded in 2017 and is located in the heart of its rural community, where it serves 5,000+ people annually. Arukah is the coordinating agency for a 42-member consortium, C5-Rural. The C5-Rural is a strong, “no wrong door” network for warmly handing off to care persons struggling with mental illness or substance use disorder/opioid use disorder (SUD/OUD) that encounter an emergency room, a physician’s office, a homeless shelter, a food pantry, a mental health professional, a law enforcement officer, a church, a school, a support group, a teen center, an employer, or any other avenue.
Specifically, the RCORP Neonatal Abstinence Syndrome (NAS) project at Arukah aims to reduce SUD/OUD in pregnant women, women of childbearing age, and mothers/families at-risk for SUD/OUD by reducing cultural, geographic, and stigmatizing barriers through four primary mechanisms: criminal justice integration, wraparound family care and services, lived-experience recovery support, and psychotherapy combined with medication for opioid use disorder (MOUD). Contributing to the success of our NAS program has been close linkages with law enforcement (LE). NAS staff have worked with LE through “ride-alongs” to engage and build relationships with high-risk individuals/families who are in active use, have a history of use, or are otherwise at high risk for developing SUD/OUD. Family services include Strengthening Families Program, a 14-week program where trained staff provide a meal and curriculum to support parents and children in life skills and healthy behaviors. NAS moms learn strategies to reduce the family’s risk of substance use problems while separately teaching adolescent children social and emotional skills. Recovery support services are designed to help initiate and sustain individual/family recovery from opioids. Recovery Support Specialists link participants to harm reduction efforts such as needle exchange, naloxone, fentanyl test strips, and sexually transmitted infection (STI) testing; they also provide companionship, information, and emotional and instrumental support. A licensed clinical social worker provides psychotherapy services for NAS participants, both individuals and families. New to the program in 2022 is a psychiatric nurse practitioner with specialties in women’s health and MOUD. These integrated services reduce barriers of access to any clinical treatment.
Key accomplishments include providing intensive services to 25 participants, ages 15–41. Eighteen participate in regular clinical treatment and 16 participate in recovery support services; three families (3 moms, 4 children) have thus far graduated from Strengthening Families Program. To date, NAS participants have engaged in over 800 contacts with Recovery Support Specialists, which has been critical to treatment engagement and longevity. Barriers overcome include increasing access to transportation, housing, MOUD, financial support, STI testing, birth control, and OB/GYN services for participants. Lastly, in 2021, the total number of fatal overdoses in the 4-county service area was reduced by 12 percent despite substantial increases in usage. We attribute this remarkable achievement in part to the important efforts put in play through the NAS program.