The Heartland House Client Intake Process

by Oct 19, 2019SUD Resources0 comments

The Heartland House Client Intake Process

Each client who applies for admission to the Heartland House program first goes through an in-depth assessment in which our team determines how we can best help them. As a benchmark, this assessment uses the widely accepted American Society of Addiction Medicine (ASAM) Criteria to provide us with insights on the client’s status of mental health and degree of substance abuse that inform the level of care needed. This prescribed level of care could include immediate admission to the Heartland House facility, based on current availability of beds; or, for those evidencing high-level health risks, referral to a medical facility. 

We begin the assessment by collecting background information from the client. This includes their court-related status (if applicable), their insurance coverage, if any; and whether they are in a program of Medication Assisted Treatment. This basic information allows us to identify any logistical needs of the client that should be addressed immediately.

Next, we learn from the client their substance abuse history, including levels and types of alcohol and drug use; and the history of the treatments that they have begun and completed. This history provides background that can prove valuable to our staff and to client, as well, in determining a treatment program that best aligns with the client’s profile. 

Now that we have basic background on the client, we begin the in-depth assessment, based on the aforementioned ASAM Criteria. There are six ASAM Assessment Criteria: (1) Acute Intoxication and/or Withdrawal Potential; (2) Biomedical Conditions/Complications; (3) Emotional/Behavioral/Cognitive Conditions/ Complications; (4) Readiness to Change; (5) Relapse, Continued Use, or Continued Problem Potential; and (6) Recovery Environment.

Here is an overview of each of them, in the order in which they are assessed:

ASAM First Assessment – Acute Intoxication and/or Withdrawal Potential

To determine Acute Intoxication and/or Withdrawal Potential, we assess the immediate health needs of our clients, with the focus on any history of serious or life-threatening symptoms when withdrawing from drugs or alcohol. If they show signs of substantial health risk, our staff will get them admitted to a hospital or detox facility before admission.  

ASAM Second Assessment – Biomedical Conditions/Complications

The second criteria assessed is the client’s physical health that extends beyond their withdrawal potential or concerns. Here we determine if the client has any chronic illnesses that will need to be treated during their stay. We also find out if they have any medications or treatments that have been prescribed for these illnesses and need to be accounted for during their stay.

ASAM Third Assessment – Emotional/Behavioral/Cognitive Conditions/ Complications

 Having separately addressed the client’s physical status, we next examine the emotional, mental, and behavioral aspects of their well-being. 

We first first determine if the client has any thoughts of hurting themself or others. If the risk appears to be high, involuntary confinement may be required for their safety. If they do not show danger signs, we next ascertain if there has been previous diagnosis or treatment of any mental health concerns such as depression, anxiety, PTSD or other mental health condition. 

ASAM Fourth Assessment – Readiness to Change

In building a customized change plan for a client, it’s essential to determine the level of their personal readiness to change. It is normal for persons new to sobriety to be hesitant to commit to extreme change, but they must have willingness to begin.

 And so we ask the client, Are you done? What does being done look like for you? Do you want to stop drinking or using, now or in the near future? How important it is for you to quit? In this line of inquiry we are seeking to learn how the client truly feels about getting sober for their own sake and not in light of any outside influences such as their family, their physician or the court system.

ASAM Fifth Assessment: Relapse, Continued Use, or Continued Problem Potential

In this assessment we review the client’s prior efforts to stop using drugs and alcohol and whether or not they were successful for any length of time. We find out the longest sober period they’ve had before, and what may have caused them to start using or drinking again after that period. We seek to learn of those “triggers” and then determine if the client is at risk to encounter these conditions in the immediate future.

We also attempt to identify the past or current coping methods that the client has used or is using in order to abstain from drugs and/or alcohol, and answer these questions: Have any of these methods been effective in the past? Does the client possibly need to learn new coping skills to augment what they have been doing?

ASAM Sixth Assessment: Recovery Environment

The sixth and final criteria is that of the client’s past and current living situation, level family and/or social support, and any other outside factors that may influence their ability to follow a recovery plan. We determine if they have been living in a home of any sort that is safe and secure or are homeless. We get an idea about who they are living with, be it friends, family or strangers. We assess with them the degree of support they can count on from any family or friends that they have; and conversely, the level of possible interference with their progress from anyone with whom they associate.

Following the ASAM Criteria-based assessment, we determine the contact information for any court-appointed individuals who have responsibilities where the client is concerned; and ascertain as applicable any court schedule(s) and the like, so that we may know of any commitments that will impact the client’s participation in their individual program at Heartland House.

Admission

Following the 6-dimensional assessment of their condition, our staff determines the level of care that the client needs and then, provided that a bed is available, we schedule them to be admitted to Heartland House.

If a bed is not currently available and the client is in immediate need of services, we contact other facilities to see if there are openings and, if so, provide the client a point of contact and a scheduled time for an interview at a facility with a vacancy.

 We sometimes encounter clients who have self-selected Heartland House and do not want to avail themselves of the services of another facility. When this occurs, we place the individual’s name on our interest list and refer them to an outpatient program. If they are unable or unwilling to participate in that program, we recommend at a minimum that they attend mutual support meetings.

If, after waiting some time for a vacant bed a client is admitted to Heartland House, our staff reviews their initial assessment to see if there are any changes or updates since we originally completed it. We show the newly admitted client around our campus and brief them on the requirements of their stay in our facility and participation in their individualized program. 

We are notably thorough in this and every part of our intake process. This is because we understand what it takes to set a man up to succeed from the moment they enter our door.

If you are interested in learning more for yourself or a loved one, please don’t hesitate to contact us.

Change in Admissions Policy in response to COVID-19View Changes

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