Mental Health and Substance Use Disorder Mobile Models
Mobile models for mental health and substance use disorder (SUD) can help reduce barriers to accessing behavioral healthcare services in rural communities, such as travel and stigma. By bringing services directly to patients, mobile programs can provide potentially life-saving care, reduce reliance on emergency departments (EDs) and hospital visits, provide prevention and education services, and address social needs that contribute to mental health and substance use issues.
Services
Mobile units can provide a variety of mental health and SUD services, including:
- Crisis management
- Individual and group therapy
- Patient education
- Peer support
- Medication management
- Naloxone distribution
- Referrals to medication for opioid use disorder (MOUD) programs
Delivery Approaches
Common models for mobile mental health and SUD service delivery include mobile units, community paramedicine, and home healthcare.
Mobile units can be driven to various locations, including homes, schools, community spaces like faith-based organizations, and areas that have high rates of substance use or mental health crises. In these locations, mobile units can deliver life-saving medication, care, and resources to individuals who would otherwise have had difficulty accessing services.
Community paramedicine models can address mental health and SUD in rural communities by providing crisis response services, including overdose response, de-escalation, immediate care services, and connection to treatment or resources. In community paramedicine, trained emergency medical service (EMS) providers meet and stabilize individuals in crisis where they are at, reducing the need for ED visits or for law enforcement involvement.
Home visitation models, including those that leverage community paramedics, can provide home visits for individuals who have been to the ED for mental health or SUD issues. These visits allow a healthcare provider to follow up on treatment, support medication management, and assess home safety to mitigate factors that would result in further crises or readmission.
The Mental Health in Rural Communities Toolkit provides additional information about mobile units for mental health. The Substance Use Disorders Prevention, Treatment, and Recovery Toolkit also provides information about mobile crisis teams for addressing SUD in rural communities.
Examples of Mobile Mental Health and SUD Programs
- The Colorado Department of Human Services Office of Behavioral Health created a mobile health service with six mobile clinics delivering MOUD services, reaching patients in rural areas of Colorado. Staff include a nurse, a licensed addiction counselor, and a peer recovery coach. The clinics offer access to prescribers who can provide MOUD prescriptions, naloxone, and referral to support services.
- Arkansas Mobile Opioid Recovery (ARMOR) uses two fully equipped mobile health units to provide Medication-Assisted Treatment (MAT), counseling, peer support, and other resources across rural Arkansas.
- Memorial Medical Clinic Mobile provides mental health support directly to students in Hancock County, Illinois. The clinic addresses anxiety, depression, and attention-deficit/hyperactivity disorder (ADHD), and provides emotional support on school campuses.
- The Edgecombe County Post Overdose Response Team/Community Paramedic Program aims to address the opioid crisis in rural and remote areas of North Carolina by providing home visits, medication management, risk assessment, interventions, monitoring, and connection to resources. Specific services provided to address SUD include naloxone, withdrawal management, blood testing, and referral and transportation to treatment.
Implementation Considerations
Rural mobile programs addressing mental health and SUD should assess community needs and tailor services accordingly. While mobile programs can be important for providing short-term resources and crisis response, rural communities can also benefit from prevention and education to address the factors that contribute to mental health and SUD issues. Understanding local gaps in services and the priorities of community members can ensure programs offer a mix of services most relevant to the population.
Partnerships with local organizations are important to establish referral pathways and address social needs that contribute to mental health and SUD challenges. For example, mobile mental health and SUD programs may consider collaborating with organizations that provide safe housing, address food insecurity, or connect individuals to employment opportunities. These partnerships can ensure continuity of care.
Due to stigma associated with mental health and SUD, mobile programs sometimes face community resistance to the operation of mobile units. Mobile programs that address mental health and SUD may consider using more discreet models of care, such as street medicine, where providers deliver services on foot directly to individuals in need. Partnerships with local entities, such as community organizations or government agencies, can also help to develop program credibility. Programs can leverage community health workers or peer support specialists who have lived experience with SUD or mental health to help reduce stigma and bridge relationships between providers and patients.
For programs providing MOUD services, it is important to ensure compliance with federal and local laws and regulations surrounding the storage, prescription, and dispensing of methadone. Strong relationships with local pharmacies, correctional facilities, and law enforcement agencies contribute to successful implementation of a mobile MOUD program.
Program Clearinghouse Examples
Resources to Learn More
Community
Paramedicine to Help People Who Use Substances
Document
Discusses how community paramedicine can support people who use substances and provides guidance for the
implementation of community paramedicine programs for SUD.
Organization(s): Community Impact North Carolina
Date: 8/2020
Implementation
of Mobile Medication Units: Findings from a Qualitative Study
Document
Describes findings on the current state of mobile MOUD units, including implementation experiences and barriers
to providing services.
Organization(s): Office of the Assistant Secretary for Planning and Evaluation (ASPE), Mathematica
Date: 1/2025
Mobile
Addiction Services Toolkit
Document
Provides guidelines to help organizations develop and implement a mobile health program offering MOUD treatment
and other addiction services to expand and integrate clinical care and related services.
Organization(s): Kraft Center for Community Health, Massachusetts General Hospital
Date: 1/2020
Strategies for the Delivery of Behavioral Health Crisis
Services in Rural and Frontier Areas of the U.S.
Document
Discusses challenges associated with providing behavioral health crisis care in rural areas and provides
strategies and opportunities for improving access.
Organization(s): National Association of State Mental Health Program Directors
Date: 8/2020