The article, “Recovery Support and Capacity Assessment Using the Calculating an Adequate System Tool: Two Case Studies,” has been published in SAj.
In this commentary, the authors state that there are multiple, reliable, and authoritative federally managed data sources for understanding the incidence and prevalence of substance use disorder (SUD) and its sequela. However, there remains a gap in metrics representing the need and capacity for treatment and related supports within local communities. To address this challenge, Calculating an Adequate System Tool (CAST) was developed in 2016 by an interdisciplinary group of researchers at the Substance Abuse and Mental Health Services Administration Center for Behavioral Health Statistics and Quality to assess the capacity of the SUD care system within a defined geographic area. It allows for risk assessment of local social and community determinants of substance abuse, as well as an assessment of local service needs across the continuum of SUD care.
In the AUTHORS’ OWN WORDS, they relate the importance of their work:
“CAST is designed to assist with short- and long-term planning for improving the behavioral health of communities. Program saturation, estimated with CAST algorithms, should be interpreted as a guide for decision-making and not a rigid boundary for program activity levels. CAST is predicated on the assumption that resources are finite and decisions need to be made about how financial and human capital are allocated within a given community. It is important to note that CAST estimates are based upon data that were provided by community organizations and not all organizations that responded to the survey provided detailed program activity information. In both the Ohio and Montana projects presented in this research brief, the logic of CAST and the quantification of need were able to elucidate community-level needs and differences in a manner that allowed for meaningful action among the coalitions that commissioned the studies.”
“Throughout the projects identified in this research brief, it has become clear that there is a need for further expansion and refinement of quantitative methods for assessing the capacity of the substance use care systems. One of the distinctive elements of CAST, as highlighted in the Missoula County case study, is quantification of prevention programming. Future research and additional efforts should be made to offer mathematical models of demand and program saturation, leveraging the progress made with CAST to improve the ability of community needs assessments to inform resource allocation.”