Center for Supportive Healthcare

The mission of the Center for Supportive Healthcare at Jefferson is to improve healthcare in partnership with people experiencing serious mental illnesses (SMI) and substance use disorders (SUD). Our focus is on developing and testing new models of care and educating healthcare professionals to deliver better healthcare and to improve health and well-being.

Our vision is a healthcare system that works for everyone!

We developed the concept of supportive healthcare to describe a range of approaches to support people with mental illness and substance use disorders to access the healthcare they need to achieve their own health and recovery goals. Supported healthcare is grounded in primary care and helps people to access care throughout the healthcare system. Supportive healthcare works to adapt the healthcare system to the person’s needs rather than the other way around. This model works to develop services and treatment approaches that consider a person’s needs holistically and recognizes that health issues may need coordinated efforts across multiple systems of care in order to improve health outcomes.

Supportive healthcare mirrors the approach of other evidence-based practices that help people with disabilities to thrive in their communities: supportive housing and supportive employment. 

• Supportive housing links affordable, community-based housing with flexible, voluntary support services to help the individual people experiencing homelessness, as well as other people with disabilities, live in the community. (USICH)
• Supported employment helps people with co-occurring mental illness and substance use disorders participate in the competitive labor market through helping people find meaningful jobs and providing ongoing support at the level of professional help they need. (SAMHSA, Bond et al 2001)

Philadelphia has a robust network of services to address the needs of people with opioid use disorder (OUD), but expansion and adaptation are urgently needed.  The fragmented OUD treatment system is not reaching or retaining many individuals who need and want to engage in treatment.  This multi-method project, MAP OUD, intended to produce foundational research about the status and capacity of the current treatment system to provide equitable access and to retain people who use drugs within services. The goal of this research was to provide insights into the accessibility of services, the reasons and timing of early treatment exit, and to identify modifiable policy-related factors related to treatment that contribute to engagement, early exit, and retention.

Lara Carson Weinstein, MD, MPH, DrPH (Co-Director) is a professor in the Department of Family and Community Medicine, Sidney Kimmel Medical College, is a family physician, addiction medicine specialist, and public health researcher working to realizing health equity in partnership with people experiencing psychiatric disabilities, substance use disorders, and complex chronic disease. Her clinical, educational, and research work is done in collaboration with two nationally recognized community organizations in Philadelphia, Pathways to Housing PA and Project HOME that provide permanent supported housing for people with experiences of homelessness and serious mental illness and substance use disorders. She provides clinical care through the Project HOME Health Services (PHHS) Federally Qualified Health Center at the PHHS Pathways to Housing PA satellite, where she is the Director of Integrated Care and Research for the Pathways to Housing PA Housing First organization.  

Dr. Weinstein serves as the program director of the Jefferson Addiction Medicine clinical fellowship. She is dedicated to supporting the careers of trainees whose experiences and perspectives are critical to building a more equitable and inclusive academic and healthcare environment.

Erin L. Kelly, PhD (Co-Director) is a research psychologist who primarily focuses on addressing health disparities for individuals with serious mental illnesses and substance use disorders. She is the director of the Jefferson Mental illness, Addiction, and Primary Care (Jeff-MAP) T32 post-doctoral fellowship program. Using stakeholder-driven methods, she is currently working on projects related to co-occurring disorders, community integration, healthcare access, management of medical conditions, and the impacts of victimizations, violence, and stigma on care among those with mental health issues. In collaboration with her practice-based research network, the Recovery-Oriented Care Collaborative (the ROCC), she is a co-PI on an NIMH R01 grant examining risk and protective factors of the social networks and treatment engagement of Black and Latinx individuals with serious mental illnesses over time. 

• Megan K. Reed, MPH, PhD
• Randa Sifri, MD
• Amy Cunningham, PhD, MPH
• Kristin Rising, MD, MSHP
• Diane Abatemarco, PhD, MSW
• Robert Sterling, PhD
• Brooke Worster, MD, FACP

HRSA T32 Jefferson Mental Illness, Addiction, & Primary Care (JeffMAP) Fellowship

This collaborative, multi-department and interdisciplinary training program will prepare 10 exceptional post-doctoral trainees to cultivate research projects in areas of urgent need in our region and nationally. This project will focus on addressing the closely interrelated priorities of ending the crisis of opioid use disorders and improving mental health access and care in integrated primary care and behavioral health settings.

Addiction Psychiatry & Addiction Medicine Fellowships

The Addiction Psychiatry and Addiction Medicine fellowships at Sidney Kimmel Medical College provide an opportunity to train in an environment known for clinical excellence, innovative community-based research, and a commitment to improving the experience of care for highly stigmatized populations.

Harm reduction is an evidenced-based, practical approach to reducing the negative personal and public health consequences of drug use.  However, staff in healthcare settings often struggle to openly discuss drug use with patients. The Introduction to Harm Reduction in Healthcare Video Series demonstrates practical strategies to support the health of people who use drugs.  Grounded in the belief that healthcare is a human right, this series supports our vision of a healthcare system that works for everyone!

• Integrated primary and behavioral health care within supportive housing for people with SMI and/or SUD
• Low-barrier primary care and treatment for people with opioid use disorders
• Harm reduction and drug-checking for people who use drugs (PWUD)
• Peer navigation
• Supporting caregivers
• Stake-holder defined definitions of recovery
• Community integration and social networks
• Improvement of medical education to address care of vulnerable populations

• Project HOME
• Pathways to Housing PA
• MATER
• NARP
• ROCC PBRN

• FORE
• HRSA
• SAMHSA

• Reed, M.K., Smith, K., *Ciocco, F., Hass, R., Cox, A., Kelly, E.L., & Weinstein, L. (2023). Sorting through life: A mixed methods approach to evaluating patient-important measures of success in a buprenorphine treatment program. Substance Abuse Treatment, Prevention, and Policy, 18(1), 4.
• Kelly, E.L., *Hong, B., Duan, L., Pancake, L., Cohen, H. & Brekke, J.S. (2021). Service use by Medicaid recipients with serious mental illness During an RCT of the Bridge peer health navigator intervention. Psychiatric Services, 72(10), 1145-1150.  
• Kelly, E., Pasquarella, F. J., Davis, L., Hunt, A., Lee, S., Fairhurst, S., Giambone, L., Murch, L., Thorning, H., & Brekke, J. S. (2021). Managing substance use for clients with serious mental illnesses: Knowledge, attitude, and training challenges among outpatient behavioral health providers in California, Ohio, and New York. Journal of substance abuse treatment, 131, 108547. 
• Lai, S., Li, E., Silverio, A., DeBates, R., Kelly, E. L., & Weinstein, L. C. (2021). "It's a place that gives me hope": A qualitative evaluation of a buprenorphine-naloxone group visit program in an urban federally qualified health center. Substance abuse, 42(4), 858–864. https://doi.org/10.1080/08897077.2021.1876202
• Alexander, K., Pogorzelska-Maziarz, M., Gerolamo, A., Hassen, N., Kelly, E. L., & Rising, K. L. (2021). The impact of COVID-19 on healthcare delivery for people who use opioids: a scoping review. Substance abuse treatment, prevention, and policy, 16(1), 60. https://doi.org/10.1186/s13011-021-00395-6
• Cabassa, L. J., Stefancic, A., Lewis-Fernández, R., Luchsinger, J., Weinstein, L. C., Guo, S., Palinkas, L., Bochicchio, L., Wang, X., O'Hara, K., Blady, M., Simiriglia, C., & Medina McCurdy, M. (2021). Main Outcomes of a Peer-Led Healthy Lifestyle Intervention for People With Serious Mental Illness in Supportive Housing. Psychiatric services (Washington, D.C.), 72(5), 555–562. https://doi.org/10.1176/appi.ps.202000304
• Leach, M., Chapin, S., Porges, I., Portner, S., Charest, T., Downing, J., & Weinstein, L. C. (2021). Evaluation of Risk Factors for Hepatitis C Virus Infection Among Philadelphia's Shelter-Bound, Homeless Population: Data from a Student-Run Hepatitis C Virus Screening Initiative. Population health management, 24(4), 448–453. 
• Weinstein, L. C., Chilton, M., Turchi, R., Klassen, A. C., LaNoue, M., Silvero, A., & Cabassa, L. J. (2021). 'It's common sense that an individual must eat': Advocating for food justice with people with psychiatric disabilities through photovoice. Health expectations : an international journal of public participation in health care and health policy, 24 Suppl 1(Suppl 1), 161–173.
• Kelly, E.L., Davis, L.,*Holguin, M., *Goana, L., Pahwa, R., Lee, S., Pancake, L., Murch, L., Giambone, L., & Brekke, J.S. (2020). Practice-Based Research Networks in stakeholder-driven Social Work research. Research on Social Work Practice, 30(8), 819-831.
• Starks, S., Kelly, E.L., Braslow, J., Meldrum, M., & Bourgois, P. (2020). Client outreach in Los Angeles County’s Assisted Outpatient Treatment Program: Strategies and barriers to outreach. Research on Social Work Practice, 32(7), 839-854
• Weinstein, L. C., Iqbal, Q., Cunningham, A., Debates, R., Landistratis, G., Doggett, P., & Silverio, A. (2020). Retention of Patients With Multiple Vulnerabilities in a Federally Qualified Health Center Buprenorphine Program: Pennsylvania, 2017-2018. American journal of public health, 110(4), 580–586. 
• Pahwa, R., Dougherty, R. J., Kelly, E., Davis, L., Smith, M. E., & Brekke, J. S. (2020). Is It Safe? Community Integration for Individuals With Serious Mental Illnesses. Research on Social Work Practice. 
  
• Weinstein, L. C., Chilton, M., Turchi, R., Klassen, A., LaNoue, M., Lamar, S., Yorgey, S., Kramer, L., Smith, I., & Cabassa, L. (2019). Reaching for a Healthier Lifestyle: A Photovoice Investigation of Healthy Living in People with Serious Mental Illness. Progress in community health partnerships : research, education, and action, 13(4), 371–383. 
• Weinstein, L., LaNoue, M., Hurley, K., Payton, C., Sifri, R., & Myers, R. (2019). Feasibility Pilot Outcomes of a Mammography Decision Support and Navigation Intervention for Women With Serious Mental Illness Living in Supportive Housing Settings. Journal of primary care & community health, 10, 2150132719867587. 
• Kelly, E.L., Braslow, J.T. & Brekke, J.S. Using Electronic Health Records to Enhance a Peer Health Navigator Intervention: A Randomized Pilot Test for Individuals with Serious Mental Illness and Housing Instability. Community Ment Health J 54, 1172–1179 (2018).
• Kelly, E., Duan, L., Cohen, H., Kiger, H., Pancake, L., & Brekke, J. (2017). Integrating behavioral healthcare for individuals with serious mental illness: A randomized controlled trial of a peer health navigator intervention. Schizophrenia research, 182, 135–141.