The Substance Use and Brain Injury Bridging Project: How to Catch a Hot Potato

By Carolyn Lemsky, PhD, C.Psych.

The Substance Use and Brain Injury Bridging Project (SUBI) grew out of the need to increase the capacity of the health care system in Ontario to better manage a group of clients who were falling into the great divide that existed between community based brain injury and addiction services. At first glance, the SUBI partners: Community Head Injury Resource Services of Toronto and the Centre for Addictions and Mental Health (CAMH), is an odd pairing — a community-based brain injury provider with only a couple of health care professionals and a large, academic medical center dedicated to additions and mental illness. The important thing about our first meetings in 2004 was that everyone around the table wanted to end the game of referral hot-potato that begins when a complex client is identified as having both a brain injury and problematic substance use. The challenge was to figure out what we could do to create meaningful change without new resources for specialized programming.