State of the Problem 

Greater Detroit area residents are suffering from substance abuse, mental illness, trauma, violence, unemployment, physical problems and many other challenges at a disproportionate rate compared to other populations. It’s estimated that 50 – 75% of Detroit’s inner city population suffers from untreated or only partially treated substance use/concomitant with mental illness. Estimates of substance abuse prevalence, based on treatment admission data for 2005, show that there are 159,513 injection drug users (IDU), 112,202 crack users, 264,480 alcoholics, and 88,852 marijuana users in the Detroit metropolitan area, although there are indications that the number of heroin injectors has since declined. Crack cocaine and Heroin are the two major drugs of abuse, but marijuana is the most widespread according to the Epidemiologic Trends in Drug Abuse for Detroit/Wayne County, June, 2007. In 2006, the City of Detroit Bureau of Substance Abuse Prevention, Treatment and Recovery (BSAPTR) admitted 11,024 individuals for substance abuse treatment. Their demographics are as follows:  37% were female, 64% were between 36-54 years old, 91% were African American, 86% had incomes below $10,000, and 70% were unemployed. Heroin accounted for 37%, cocaine/crack for 25% and alcohol for 21% of admission. The Michigan Department of Community Heath (MDCH) estimates that fewer than 1 in 44 persons with a substance abuse problem receive treatment services for which they are clinically eligible, and in Detroit, while the estimate of substance abuse users with mental health issues is roughly 50%, only 17.8% of those admitted by the Bureau of Substance Abuse Prevention, Treatment and Recovery (BSAPTR) had a reported mental health disorder as a factor in treatment. This is in contrast to the statewide average of 32.5% of admissions. Anecdotal evidence suggests that in the Greater Detroit area, those with PTSD or trauma related disorders do not disclose their mental health status for fear of being completely rejected and/or discharged from treatment prematurely.

While generations perish – sometimes quickly and other times slowly, researchers and social scientists can find many causal relations and contributing factors for this pandemic, but are unable to agree on a time sensitive solution. A few people will attempt to discount the severity of this situation or the need for a rapid response by highlighting the social programs that are already in place. The fact is, there are programs, but frequently the population in need do not trust the caregiver. There’s help available, but systemic problems exist with the proper coordination of services. Certainly, there are services available, but due to proximity, insurance and cost, eligibility, trust and multiple layers of bureaucracy, we have problems with access. If we continue to do what we’ve always done, then we will continue to get the results we’ve always got – and it’s not working.

Enhancing Community Health Outreach (ECHO) is our answer to this service delivery nightmare.

Introducing SHAR’s ECHO Project

Since 1969, Self-Help Addiction Rehabilitation, Inc. (SHAR) has provided the needed substance abuse and other behavioral health services for the residents of the Greater Detroit area. As a well known and respected agency that is licensed by the State of Michigan and accredited by CARF, SHAR has remained on the front line developing and implementing innovative treatment strategies with an outstanding record of community-based accomplishments. 

We know that great therapeutic benefit, life readiness and change occur within the walls of programs like SHAR. We find testimony after testimony from individuals and families who talk about their recovery process and demonstrate that “recovery works”. While SHAR and other human service agencies have done a commendable job in working with the various clients who come through our doors, there remain huge service gaps consisting of individuals who need services but who do not access services for a multitude of reasons. Behavioral health and other healthcare professionals strongly believe and adhere to the philosophy that “if the individual doesn’t come to us, we can’t provide services; but if they come, we will give them our best”. In the meantime, there are large numbers of people who remain lost with untapped potential, with lifestyle choice challenges that adversely contribute to health conditions and ailments - draining public dollars and destroying the fabric of families and our communities.

In collaboration with the Office of Faith-Based and Neighborhood Partnerships (OFNP) - Clergy Leadership Advisory Council, a major multi-denominational faith-based entity, SHAR has developed an innovative, strategic plan called ECHO to address the horrific social problems within the Greater Detroit area. We are confident and believe that our “best” will become obvious by introducing a “therapeutic community without walls” to targeted local communities through established outreach sources. We are confident and believe that with the support of the Office of Faith-Based and Neighborhood Partnerships, our project will successfully transform the heart of the greater Detroit area into a more stable society by making a community-spectrum of FREE services accessible through 9 primary faith-based sites -each having 4 additional supplemental sites or satellites.

We acknowledge that a host of highly competent and service-specific State agencies currently offer assistance and resources across the state and for the Greater Detroit area. ECHO is designed to compliment these agencies by reaching deeper within each local community to identify marginally functioning and/or potentially highly functioning residents who clearly have unresolved challenges – before these challenges exacerbate and become so acute or chronically debilitating that they necessitate a disproportionate amount of the resources available through already strained local, county and state agencies.

Too often, clients completing a treatment program or offenders released from incarceration, are effectively ‘discharged’ right back into the same environment that continues to have the same factors present that precipitated their admission or incarceration. It stands to reason and is well documented that when individuals return back to the same unstable or crime riddled community, they are hard-pressed to avoid the same unhealthy lifestyle choices and conditions that originally brought them into treatment or prison.  For a healthier transition back and an enhanced potential for recovery, we must not only touch the “identified client”, but the conditions within their family and the community as well. 

ECHO will work because it functionally becomes a local agent for change in this State of Michigan- faith based community partnership.

An appropriate analogy would be to view ECHO and its faith-based sites as an auto manufacturing or repair network. The ECHO network of faith-based sites provides a multitude of product(s)/services that is vital to the longevity and the marketability of the residents. The existing system (pre-ECHO) is hugely challenged to efficiently respond to the changing demands for new resources, products and services in mass without a change agent or ‘manufacturer’. Like an auto manufacturer, ECHO becomes an efficient change agent that retools based on consumer strengths, needs, abilities and preferences. Through this innovative state-community delivery system, ECHO is capable of creating a real call to action and change the negative culture that exists in each of the targeted communities. We also believe that the innovative model we have developed can be easily applied to other cities and areas throughout Michigan and beyond.