ASSMCA treatment: which programme fits you and where it is

ASSMCA is the Mental Health and Anti-Addiction Services Administration, and its Auxiliary Treatment Administration runs the programmes where people are actually seen. The Children, Youth and Families Division works with the System of Care model and classifies services in levels running from least restrictive to most restrictive: there are residential, intensive ambulatory and ambulatory services across the island, with child and adolescent psychiatrists, psychologists, social workers, counsellors, pediatricians, physicians, nurses, occupational and recreational therapists and peers. Adult services include addiction treatment and diversions coordinated with the justice system. Recovery-oriented services aim for a person with a mental health condition to reintegrate and stay in the community, and they are transitional, not permanent. The homeless division serves people who are homeless or at risk of becoming homeless. And hospital services include two forensic psychiatry hospitals that assess mental competency under Rules 240 and 241 of Criminal Procedure, and a psychiatric hospital with evaluation and treatment in the acute and sub-acute phase.

It depends on the programme, which is why it matters to know which one to ask for. By age: ReME serves minors of both sexes up to age 12; SeRA, adolescents 13 to 17; the Centros Iniciativa, 4 to 17; the Río Piedras Children and Adolescents Clinic, up to 17; Juvenile TASC, 13 to 17; the Vieques unit, 4 to 17 years and 11 months; the Puedo project, 16 to 25; the Specialized Services Centres for Minors, 5 to 20; the PR Youth and Family Tree project, 12 to 18; PROCCER, ages 16 to 35 with psychosis for more than a week and less than three years. The adult programmes — CTIAM, SEVAS, TASC, ambulatory and residential treatment, PATH — are for people 18 or older. By condition: CTIAM serves a diagnosis of problematic use of opium-derived substances, under the Harm Reduction model; the Compulsive Gamblers Help Program serves problems with or addiction to games of chance or betting. By route in: SEVAS serves people sentenced by the court for violating Articles 7.02 or 7.03 of the Vehicle and Traffic Act; SERE serves employees referred by public agencies and private employers over positive substance tests, and people referred by the DTRH Habilitation Office; the Ambulatory Treatment Centres serve people referred by the courts, by the Drug Courts or by TASC; TAC takes court referrals under Ley 408, and referrals from providers, family and hospitals.

• ReME (residential for minors): be 12 or younger, with severe emotional disturbance, complex trauma or another clinical mental health disorder.Verified against the official source
• SeRA (residential for youth): be between 13 and 17 with severe emotional disturbance.Verified against the official source
• CTIAM: be over 18 and have a diagnosis of problematic use of opium-derived substances.Verified against the official source
• SEVAS: be 18 or older and have been sentenced by the court for violating Article 7.02 or 7.03 of the Vehicle and Traffic Act.Verified against the official source
• PROCCER: be between 16 and 35 and have experienced psychosis for more than a week and less than three years.Verified against the official source
• PATH: be 18 or older, with a severe mental health diagnosis, a substance use disorder or a co-occurring disorder, and be homeless or at risk of becoming homeless.Verified against the official source

Information pending verification.

1. 1

   Step 1: If you do not know where to start, start with Línea PAS

   ASSMCA’s Línea PAS — 1-800-981-0023, or 988 — coordinates ambulatory and hospital psychiatric and psychological evaluation, and coordinates ambulatory and inpatient drug and alcohol rehabilitation programmes. It is staffed 24 hours a day, 7 days a week. It is the shortest way to have someone who knows the system tell you which of these programmes fits, instead of you calling five numbers.

2. 2

   Step 2: If it is a child or a teenager

   ReME is the residential treatment clinic for minors up to age 12 with severe emotional disturbance, complex trauma and other clinical disorders; treatment lasts roughly six to eight months and is offered 24 hours a day, seven days a week, at ASSMCA’s central offices in Bayamón, Villa #15, Carr. #2 Km 8.2 Bo. Juan Sánchez, at 787-763-7575 ext. 1524 and 1526. SeRA is the residential clinic for adolescents 13 to 17 with severe emotional disturbance, same address, ext. 1511, 1512 and 1519. The Centros Iniciativa serve ages 4 to 17 with the Wraparound model in Moca, Vieques, Culebra, Manatí and Yauco. The Río Piedras Children and Adolescents Clinic offers ambulatory mental health and substance treatment up to age 17, on the third floor of the Pediatric Hospital at Centro Médico, at 787-777-3201 ext. 7266, 7275, 7277 and 7474. In Vieques, the Ambulatory Treatment Unit serves ages 4 to 17 years and 11 months at the Susana Centeno CDT, at 787-741-2550, designed for families without health insurance or who find it hard to travel to the main island.

3. 3

   Step 3: If the teenager’s problem is substances or there is a court case

   Juvenile TASC serves youth 13 to 17 and its purpose is to divert the minor offender who is involved in, or at risk of becoming involved in, criminal activity related to substance or alcohol abuse or dependence, toward treatment programmes. It serves the San Juan, Bayamón and Arecibo judicial regions: at the San Juan Judicial Centre, Minors and Family Social Unit, at 787-641-6363 ext. 2352; at the Bayamón Judicial Centre at 787-620-9790 ext. 2661; and in Arecibo, at the old District Hospital, Carr. 129 Km 1.0 Ave. San Luis. The PR Youth and Family Tree project uses Multidimensional Family Therapy with youth 12 to 18 with substance use disturbance, on the third floor of the Pediatric Hospital at Centro Médico, at 787-777-3201 ext. 7266, 7277 and 7474.

4. 4

   Step 4: If it is an adult with opioid addiction

   The Medication-Assisted Integrated Treatment Clinics (CTIAM) serve people over 18 with a diagnosis of problematic use of opium-derived substances, under the Harm Reduction model, with medical, nursing, psychological and social services, plus a specialized service for women. There are CTIAM clinics in Aguadilla (Hospital Buen Samaritano, Calle José de Diego PR 22), Arecibo (Carr. #129, Ave. San Luis, old District Hospital, 787-635-9699), Bayamón (Carr. #5 Km 6.1, Industrial Lucchetti, Bo. Juan Sánchez, 787-786-4370 and 787-269-3045), Caguas (Bo. Bairoa, Sector La 25, Carr. #796 Km 0.5, 787-745-0410 and 787-745-0685), Cayey (Calle José De Diego #392 Oeste), Coamo (Hospital Menonita, 787-825-3636), Mayagüez (Carr. #2, Centro Médico Dr. Emeterio Betances, Mental Health Facilities Annex), Ponce (San Lucas II Hospital area, Carr. #14, Bo. Machuelos, 787-840-6630 among others), San Juan (Centro Médico, Bo. Monacillo, Pavilion G, Río Piedras, 787-754-4100 and 787-754-4123) and Fajardo (Fajardo Ambulatory Centre, 787-860-0967 and 787-860-1987). One honest warning about this list: ASSMCA publishes the same four phone numbers — 787-882-2566, 787-882-2377, 787-891-2352 and 787-891-2360 — for both Aguadilla and Mayagüez, and publishes no phone for Cayey. This guide does not guess which is which.

5. 5

   Step 5: If the court sent you for driving under the influence

   The Specialized Services Program for Alcohol- and Substance-Free Roads (SEVAS) offers pre-sentence evaluations, socio-educational talks, evidence-based treatment and a Victim Impact Panel to people 18 or older sentenced by the court for violating Articles 7.02 or 7.03 of the Vehicle and Traffic Act. The central office is 787-763-7575 ext. 1717. SEVAS is offered by region and each centre serves specific municipalities: San Juan (787-751-4014 and 787-756-6425), Ponce (787-848-2491 and 787-841-7449), Fajardo (787-860-1987), Arecibo (787-817-0383 and 787-817-4421), Mayagüez (787-833-0663 ext. 217) and Moca (787-877-3241 and 787-877-3538). Call the one for your region and ask whether your municipality belongs to it: ASSMCA publishes each centre’s list of municipalities.

6. 6

   Step 6: If the problem is gambling, or a drug test at work

   The Compulsive Gamblers Help Program (PAJC) serves people with problems with or addiction to games of chance or betting, with group and individual therapy and psychoeducation, and ASSMCA states expressly that the programme’s services are free for the person and their family members. Everyone who requests services will be evaluated by the necessary clinical professional to determine the level of care. It is in San Juan (787-753-4665), Ponce (787-848-2491 and 787-841-7449) and Mayagüez (787-833-0663 ext. 217). The Employee Evaluation and Recovery Services Program (SERE) serves employees referred by public agencies and private employers for testing positive for substances in the workplace, and also evaluates employees with difficulties performing their duties because of a mental disorder or a work situation, and people referred by the Labor Department’s Habilitation Office. It is ambulatory.

7. 7

   Step 7: If there is a criminal case and you want diversion to treatment

   The TASC Program offers people over 18 with addiction problems a diversion alternative conditioned on participating in treatment; under Rule 247.1 of Criminal Procedure it provides a special probation that lets the court order the case dismissed and closed without it being considered a conviction. It is in the Aguadilla region (Calle Barbosa #242, Moca, 787-877-4747 and 787-877-4746), Utuado (Utuado Judicial Centre, 2nd floor, 787-894-3296) and Aibonito (Calle José C. Vázquez #60, 787-894-3296). The Specialized Controlled Substances Courtrooms Program, known as the Drug Courts, offers diversion to treatment focused on recovery and reducing reoffending, and is in the judicial centres of Arecibo, Bayamón, Caguas, Carolina, Fajardo, Guayama, Humacao, Mayagüez, Ponce and San Juan. ASSMCA’s Ambulatory Treatment Centres — San Juan, Fajardo, Ponce, Arecibo and Mayagüez — serve precisely those people referred by the courts, by the Drug Courts or by TASC, at three levels of ambulatory care. And there are Residential Treatment Centres for people over 18 with addictive and co-occurring disorders: the San Juan Women’s Residence (787-764-0684), the San Juan Men’s Residence (787-767-0892 ext. 274 and 1633) and the Ponce Men’s Residence (787-840-6835).

8. 8

   Step 8: If what is needed is to sustain recovery

   The Ambulatory Recovery Centres work with the recovery model so that a person with a mental health disorder reintegrates and stays in the community, with teams of psychologists, social workers, nurses, recreational and occupational therapists and recovery specialists. They are in Metro San Juan/Bayamón (Calle Cañada 1324, Ave. De Diego, Puerto Nuevo), East Fajardo (787-860-1987 ext. 262), Northeast Carolina/Trujillo Alto (939-268-5223, 939-277-0452, 939-260-5397), North Arecibo, South Ponce/Guayama (787-259-7833 and 787-844-0101 ext. 289) and West/Northwest Mayagüez (787-833-0663 ext. 203 and 253). ASSMCA’s Residential Services in Bayamón (787-763-7575 ext. 1808 and 1809) are transitional, not permanent, to achieve the transition to less restrictive settings. The Independent Living Recovery Centres are in Trujillo Alto and San Germán. Camino a Casa accompanies the move from one level of care to another, in Puerto Nuevo, at 787-706-7946. PROCCER, in the west, serves people 16 to 35 who have experienced psychosis for more than a week and less than three years, with medical care, psychotherapy, low doses of medication, help finding work or continuing studies, and family support, at 787-833-0663 ext. 238, 259 and 297.

9. 9

   Step 9: If the court ordered treatment under Ley 408

   The Community Assisted Treatment Program (TAC) is a supervised community ambulatory services programme, in the west and northwest, that helps stabilize people with mental health disorders referred by the court under Puerto Rico’s Ley 408 on mental health, and also by service providers, family and hospitals. It does screenings and comprehensive assessments, integrates individual, group and family interventions, coordinates physical health treatment and coordinates hospitalizations, and includes counsel aimed at protecting the civil and legal rights of people with mental disorders. It is at Ave. #2 Barrio Sábalos, behind the Mayagüez Medical Center, at 787-833-0663 ext. 238, 259 and 297.

10. 10

    Step 10: If the person is homeless or about to become homeless

    PATH serves people 18 and older with severe mental health diagnoses, substance use disorders or co-occurring disorders, who are homeless or at risk of becoming homeless, with services available across Puerto Rico, from Bo. Machuelo Carr. #14 next to the Ponce Forensic Psychiatry Hospital, at 939-438-3552. De Vuelta a la Vida I is transitional housing for men over 18 who can care for themselves, with a stay of roughly 18 months, in Bayamón, at 787-995-5191. De Vuelta a la Vida II seeks permanent housing, in Bayamón, at 787-787-4343. De Vuelta a la Vida IV offers permanent housing with 20 vouchers, mostly in the south. PAYAC does community outreach and impact routes across the island, at 787-787-4343. COSS serves vulnerable communities. The Community Reinsertion Program accompanies people leaving prison, in Ponce, Bayamón, Mayagüez, Aguadilla, Arecibo and Guayama, at 787-766-4655 ext. 5026. And the Multisectoral Council in Support of the Homeless Population, created by Ley 130-2007 and attached to ASSMCA, covers all 78 municipalities, at 787-763-7575 ext. 1735.

11. 11

    Step 11: The hospitals

    The Ponce Forensic Psychiatry Hospital provides medical-legal evaluation to men and women 18 or older with mental disorders who have been processed by the criminal justice system, when mental competency must be established under Rules 240 and 241 of Criminal Procedure, at the Ponce Regional Hospital, at 787-844-0101. The Río Piedras Forensic Psychiatry Hospital does the same for men 18 or older, at Centro Médico, Calle Maga Bo. Monacillos, at 787-764-3657 or 787-758-8019 ext. 2212, 2114 and 2929. The Dr. Ramón Fernández Marina Psychiatric Hospital in Río Piedras provides psychiatric evaluation and treatment to people over 18 in the acute and sub-acute phase of mental illness, with an Evaluation and Screening Unit and acute care units, and offers 24-hour psychiatric emergency services, at Centro Médico Río Piedras, at 787-766-4646.

If you do not know which programme fits, start with Línea PAS: 1-800-981-0023 or 988, 24 hours a day, 7 days a week. The switchboard at ASSMCA’s central offices in Bayamón, Carr. #2 Km 8.2 Bo. Juan Sánchez, is 787-763-7575. Every programme in this guide has its own address and its own extension, and ASSMCA publishes them on its Tratamientos page.

• Calling a single ASSMCA number and giving up when they say that case is not handled there.
• Not saying the age: nearly all of these programmes are defined by age range.
• Looking for adult residential treatment when the person is under 18, or the other way around.
• Not mentioning there is a court case, which is what opens TASC, the Drug Courts, SEVAS and TAC.
• Assuming every service is free: ASSMCA says so expressly only of the Compulsive Gamblers Help Program.
• Thinking a first psychotic episode has no programme: PROCCER exists for that, ages 16 to 35.
• Not using Línea PAS and letting them coordinate the evaluation.

These are the government pages this guide is based on.

• Administración de Servicios de Salud Mental y Contra la Adicción (ASSMCA)

  ASSMCA

  www.assmca.pr.gov

• ASSMCA Línea PAS

  assmca

  www.assmca.pr.gov