Did You Know

2023 August

Breaking Down Silos:



Communities confronting the opioid crisis across the country are breaking down barriers between law enforcement, health care, and recovery services to better address the overdose epidemic. Research shows that when silos are broken down in a coordinated effort to reduce opioid deaths, it results in:

    1. increased safety
    2. improved behavioral health outcomes, and
    3. cost savings.

Both observational studies and economic models have demonstrated that opioid education and naloxone distribution programs prevent death and are cost effective if focused on those places and people who are at a higher risk of overdose. Furthermore, an article from the National Institutes of Health (NIH) confirms the effectiveness of partnering with community based organizations to distribute Naloxone:

Dr. Bailey and fellow researchers looked at the promising results of community-based post-overdose interventions — projects where outreach teams follow up with overdose survivors.1 This article examined other studies from 2001 – 2021 in which multisector outreach teams follow-up with those who have recently overdosed. 60% of the programs were successful in navigating people from near-fatal overdose to treatment/recovery programs.

The methods, evaluations, and outcomes of these programs varied, yet all of the programs focused on:

Building on Bailey et al’s research, SAMHSA released guidelines for behavioral health-first responder programs last week. Please click here.

Whether it’s naloxone distribution partnerships or post-overdose follow-up calls, breaking down silos is a more cost-effective way of providing support for those with substance use issues. Creating these ecosystems of support for our residents has been demonstrated to generate great benefits for organizations regardless of sector. World Economic Forum surveys those organizations with high performing ecosystems and found that 65% of respondents claimed that business alliances, coalitions, and partnerships increased efficiency or reduced their cost.3

Specifically, a recent survey of business leaders operating within at least one ecosystem attribute on average the following benefits of working in this way:


Law enforcement agencies throughout the Tampa Bay region are taking the lead in breaking down silos to improve health outcomes and reduce the number of opioid overdose deaths. St Petersburg, FL is one example, where the Chief of Police, Anthony Holloway, led development of the Community Assistance and Life Liaison (CALL) program, directing social workers and other trained professionals to refer non-criminal calls to the 911 system.

Live Tampa Bay’s CEO, Jennifer Webb, invited Chief Holloway to discuss the origins of the CALL program as part of Live Tampa Bay’s July 20th webinar on Breaking Down Silos.

Link, Lunch and Learn July 20th


Getting people with different backgrounds and expertise to start working together doesn’t just happen because someone declares it a priority. It takes work and careful management. A Harvard Business Review article examines the kinds of conversations that must happen for people in silos to start breaking down the barriers to effective collaboration and creating better outcomes.4

What’s the key to making the connections that will break down silos?

Encouraging people to ask the right questions and begin to see their shared priorities from a very different point of view.


Tools – The Four-Quadrant Model

Behavioral health providers who are interested in further breaking down silos in your work or in organizing your work using tested frameworks may want to check out the article on the quadrant framework. Dr. Bonfine and her colleagues describe ways health service providers can begin to integrate complex needs through a four-quadrant model assessing relative needs regarding mental health and substance use. 5

As you can see from the model above, each quadrant depicts possible classification and service responses for clients on the basis of the level of need they manifest for each disorder. For example, people with low mental health and low substance use needs (quadrant I) have different treatment and service needs compared with people who have high mental health needs but low substance use needs (quadrant II), and these individuals differ from people with high mental health needs and high substance use needs (quadrant IV).


The movement to break down silos in behavioral health is unlocking big wins for law enforcement, health care, and recovery support services. It takes making time for conversations that require deep curiosity and a willingness to listen. Practitioners who learn how to see their field through the eyes of people with a whole different perspective have the chance to integrate their services in ways that save lives, improve safety for everyone involved, and make their programs more cost effective.

Special thanks to Timothy Freeman Gerhardt, PhD candidate, College of Behavioral Health, University of South Florida, for assistance in preparing this article.

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