System Building

While not part of the traditional Institute of Medicine's (IOM) Continuum of Care model, systems building strategies allow community leaders to build big picture vision, address underlying values, and change the source of conditions. This may include strategies that support your broader work, such as building public awareness and momentum around your movement, broadening and engaging your coalition, supporting advocacy efforts, applying data performance approaches, and leading policy change.

The themes addressed below are tightly linked to issues addressed across the full spectrum of the IOM Continuum of Care, and the reader is strongly encouraged to read the overview articles in each of the other five SAFE Solutions menus (prevention, early intervention, treatment, harm reduction, and recovery).

Three clusters of system-building articles are outlined. The first menu, "Principles of Systems Thinking," addresses the methodology of system building and creates a foundation for all of the other articles. The second menu details each of the five phases of SAMHSA's Strategic Prevention Framework (SPF). The last menu addresses themes introduced in the articles on systems thinking principles as they apply across the Continuum of Care and throughout the SPF phases.

Principles of Systems Thinking include:

• "Systems Change Science" explains the methodology of systems thinking and change generally and its importance in addressing fundamental root causes to improve outcomes, rather than symptoms of a problem.
• "Apply a Multi-Sectoral Approach" covers the breadth of agencies and stakeholders to engage in the kind of community-wide systems change initiative needed to end the substance use crisis.

Solutions which focus on the SPF include:

• "Collect and Share Data" covers the first of the five SPF phases, assessment, and the need to collect, share, and monitor data at the local level in order to implement a data-driven approach.
• "Build Capacity" addresses the second SPF phase and provides methods for new and mature coalitions to deploy to improve community impact.
• "Plan, Implement, and Evaluate" addresses the last three phases of SPF and highlights the way in which the three are interrelated.

The third menu, "Cross Cutting Strategies," are strategies that should be applied across the entire Continuum of Care and includes:

• "Apply a Health Equity Lens" addresses how determinants and conditions by which people are born are impacted by substance use and how to apply a health equity lens in all approaches, so that all people have access to high-quality health. This article is under development for release in 2025.
• "Intersectionality and Addressing Disparities" addresses the enhancement of protective factors linked to substance use prevention and approaches in other intersecting areas like domestic violence, gun violence, suicide, and a variety of others. It specifically addresses disparities and unequal distribution across various groups of people impacted by substance use and highlights key needs. This is an article under development for release in 2025.
• "Mobilize Community Champions" focuses on applying motivational interviewing at the community scale and building champions outside of a coalition. This is an article under development for release in 2025.
• "Advocate for Policy Change" addresses various strategies and levels of engagement for changing policy at the local, state, and federal levels.
• "Understand Funding and Identify Your Resources" highlights various funding sources and strategies for funding and sustaining community efforts. This is an article under development for release in 2025.
• "Build Awareness and Education" focuses on communications tactics for educating the general public and elevating your community efforts. This is an article under development for release in 2025.
• "Reduce Stigma" defines the various types of stigma and examines strategies for stigma reduction in the prevention, treatment, and recovery domains.