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Why is Cross-Training Needed?

Cross-Training is needed to address the challenges of today's health care environment. The AIDS epidemic and blood-borne illnesses such as hepatitis B and C have led to a growing recognition of the importance of preventing and treating injection drug use. Designing and delivering effective interventions for injection drug users (IDUs) who have or are at high risk of HIV/AIDS and other infectious diseases requires that service providers and others better understand the lives and issues faced by IDUs and work to overcome personal and societal biases that may keep such individuals from getting needed care.

Many professionals in the public health, mental health, criminal justice, and substance abuse health care delivery systems have been inadequately prepared, either through training or experience, to fully address the complex needs of substance-abusing patients infected with HIV/AIDS, STDs, tuberculosis, or viral hepatitis. Cross-Training brings together professionals in public health, substance abuse, mental health, and criminal justice health care delivery systems to increase their understanding of both substance abuse and infectious diseases so that they can strengthen the network of resources available to their clients and patients.

Cross-Training is unique in bringing public health, substance abuse, mental health, and criminal justice systems together in a shared learning environment to be trained by a team that includes experts from the different service areas and disciplines. Through the Cross-Training process, critical knowledge and skills are transferred, and a climate is created for building important linkages in the community. In addition to enhancing knowledge and skills required by multiple disciplines, the Cross-Training process allows participants to explore the attitudes, sensitivities, and the interrelated health and confidentiality issues faced by clients and service providers that could pose barriers to integration of care.

Cross-Training creates synergy among providers, so that they can learn with and from each other, share best practices, and attempt to overcome personal beliefs and perspectives about patients' behavior, as well as religious or moralistic thinking that serves as a barrier to the provision of needed services. Participants develop an appreciation of each others' views, as well as an understanding of the funding, policy, and eligibility requirements that influence the scope of services that can be provided to patients. The workshops change attitudes and alter the ways that many participants work with clients, creating collaborations and service agreements.

Ultimately, it is hoped that concomitant screening for substance abuse, HIV/AIDS, STDs, viral hepatitis, and TB will facilitate access to health care for at-risk individuals by promoting early identification of these problems. In addition, the appropriateness and specificity of treatment placement can be improved when a dually diagnosed client is accurately screened. The risk of illness and spread of disease to the community will thereby be reduced.

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