EXHIBIT 2.2. Making “No Wrong Door” a Reality

The consensus panel strongly endorses a “no wrong door” policy: effective systems must ensure that an individual needing treatment will be identified and assessed and will receive treatment, either directly or through appropriate referral, no matter where he or she enters the realm of services (Center for Substance Abuse Treatment [CSAT], 2000a).

The focus of the “no wrong door” imperative is on constructing the healthcare delivery system so that treatment access is available at any point of entry. A client with CODs needing treatment might enter the service system by means of a primary care facility, homeless shelter, social service agency, emergency room, or criminal justice setting. Some clients require creation of a “right door” to enter treatment. For example, mobile outreach teams can access clients with CODs who are otherwise unlikely to seek treatment on their own.

The “no wrong door” approach has five major implications for service planning:

1.

Assessment, referral, and treatment planning across settings is consistent with a “no wrong door” policy.

2.

Creative outreach strategies are available to encourage people to engage in treatment.

3.

Programs and staff can change expectations and program requirements to engage reluctant and “unmotivated” clients.

4.

Treatment plans are based on clients’ needs and respond to changes as they progress through stages of treatment.

5.

The overall system of care is seamless, providing continuity of care across service systems. This is only possible via established patterns of interagency cooperation or clear willingness to attain that cooperation.

Source: CSAT (2000a).