Description and Initial Evaluation of a Postdischarge Intervention to Support Transition of Care in Substance Use Disorder Treatment

Objectives:This paper describes an interdisciplinary outpatient service developed during the COVID-19 pandemic to support and ensure continuity of care for patients with substance use and concurrent mental health disorders. Methods:This service provides 2 weeks of intensive mental health and addiction support to patients recently discharged from the hospital. Here we describe the formation of the service, data on service utilization, and initial qualitative evaluation of the patient experience with this service. Results:Patients accessing this service had high rates of treatment engagement, with an average of 5.6 visits per patient, and were most commonly receiving treatment for alcohol (68.0%), stimulant (47.7%), and opioid (37.3%) use disorders. Patients reported positive experiences with the service, valuing the high frequency and low-barrier contact. Conclusions:Interdisciplinary teams providing brief and intensive interdisciplinary support to patients with substance use disorders after inpatient hospitalizations are feasible and well-received by patients.