Providers’ Perspectives on Treating Patients for Substance Use Disorder in Northeast Tennessee Stefan Pienkowski MA, Abbey Mann PhD Department of Family Medicine, Quillen College of Medicine, East Tennessee State University, Johnson CIty, TN ABSTRACT Previous research has shown that people who identify as lesbian, gay, bisexual, transgender, and/or queer/questioning (LGTBQ+) have higher rates of substance use disorder (SUD) compared to the general population.1,2 Additionally, gender and sexual minorities have shown less treatment-seeking intentions than their heterosexual cis-gender counterparts.3 Given these circumstances, increasing approachability to SUD treatment options for people who identify as LGBTQ+ may significantly reduce this health disparity. Through this action research study, we set out to identify barriers to SUD treatment in northeast Tennessee as well as identify SUD treatment providers that make special accommodations for people who identify as LGBTQ+. Through purposive sampling, we identified nine providers of SUD treatment in Washington, Carter, and Sullivan counties. Providers included three physicians, three certified peer support specialists, a licensed counselor, and two facility directors. Providers each participated in a one-on-one semi-structured interview that lasted approximately 45 minutes and was audio recorded without the use of identifying information. Interview data were reviewed, and preliminary analysis was performed in order to identify themes. Themes included barriers to care, general resources, and stigma. LGBTQ+ specific findings revealed that none of the interviewed providers had received formal LGBTQ+ cultural competency training, but most providers expressed interest in receiving LGBTQ+ cultural competency training. Additionally, many providers did not believe that LGBTQ+ patients have specific needs concerning SUD treatment. Only three of the providers interviewed made special accommodations for their LGBTQ+ patients. In addition to identifying themes in the interview data, the results of this project were used to create a LGBTQ+ friendly SUD treatment resource guide for northeast Tennessee. Next steps for this action research project include 1) interviewing people who have experience with SUD treatment in northeast Tennessee and identify as LGBTQ+, 2) developing a community-based LGBTQ+ cultural competency training module informed by those interviews, 3) implementing and evaluating that module with SUD treatment providers in northeast Tennessee. 1. Medley, Grace, et al. “Sexual Orientation and Estimates of Adult Substance Use and Mental Health: Results from the 2015 National Survey on Drug Use and Health.” Substance Abuse and Mental Health Services Administration, Oct. 2016, www.samhsa.gov/data/sites/default/files/NSDUH-SexualOrientation-2015/NSDUH-SexualOrientation-2015/NSDUH-SexualOrientation-2015.htm. 2. Mereish, Ethan H, and Judith B Bradford. “Intersecting Identities and Substance Use Problems: Sexual Orientation, Gender, Race, and Lifetime Substance Use Problems.” Journal of Studies on Alcohol and Drugs, Rutgers University, Jan. 2014, www.ncbi.nlm.nih.gov/pubmed/24411810.` 3. Benz, Madeline. “Stigma and Help-Seeking: The Interplay of Substance Use and Gender and Sexual Minority Identity.” Addictive Behaviors, Pergamon, 23 May 2019, www.sciencedirect.com/science/article/abs/pii/S0306460318311316.

Implementation of Evidenced-Based Practices to Improve Follow-up Care Following Inpatient Mental Health Hospitalizations. Jacqlyne W Bowman, Dr. Judy Rice, Dr. Beth Schreiner, Dr. Ernie Maupin, College of Nursing, East Tennessee State University Persons hospitalized for mental health conditions are frequently lost to follow up after discharge. The aim of this quality improvement project is to increase the rate of attendance at follow up appointments after hospital discharge back to the community. The focus of this project is the development and implementation of a discharge questionnaire for both clients and case management to better understand the needs of the clients during the discharge process. Behavioral health technicians employed by the agency are including the discharge questionnaire in the admission packet for a 12-week trial period. This discharge questionnaire asks clients their preferred location for follow up appointments, if they are active in their care, if transportation is needed for follow up appointments and verifies the patient’s phone number. Clients complete the discharge questionnaire and return it to the behavioral health technicians with their admission packet. The discharge questionnaire is then given to case managers to assess and address concerns outlined on the questionnaire. Data will be gathered over 12-weeks to determine if the rate of non-attendance decreases with the integration of the questionnaire. The project is in the implementation phase. The anticipated outcome is there will be an increase in the rate of attendance at follow-up appointments post discharge with the use of the discharge questionnaire. By utilizing the discharge questionnaire, case managers will be better able to determine barriers that lead to non-attendance to follow up appointments. With the barriers identified and addressed, individuals will be more likely to attend their follow-up appointments and medication compliance and rates of re-hospitalizations will improve.