To address the grave issue of substance misuse and the resulting fatalities in Marion County, the largest county in Indiana, the Marion County Public Health Department (MCPHD) formed a multidisciplinary overdose fatality review (OFR) team in November 2020 with the purpose of recommending data-driven changes based on the circumstances around overdose deaths in the county. From December 2020 to May 2022, a total of 33 overdose deaths were reviewed, and seven themes emerged, with the top three being mental health and stigma, health care access, and substance use awareness. After a year of case reviews, the team decided to form three action-oriented subcommittees based on the recommendations: (1) grief support, (2) advocacy, outreach, and information, and (3) access to care. Despite barriers, the subcommittees are continuing to perform exceptional work in terms of converting recommendations into action. The OFR team identified that families of decedents need easy access to grief support and mental health resources, especially at the coroner’s office, when their grief is still fresh. The grief support subcommittee acted by assembling grief support and mental health resources to share with the grieving families. It also advocated for the addition of a social worker among the coroner’s office staff who is trained to educate the family members regarding substance misuse and mental health needs. This has fostered empathetic surroundings for the families and encouraged them to seek help from the right sources. This initiative is a significant step toward reducing substance use stigma in the community.
Keywords: substance misuse multidisciplinary overdose fatality review OFR data-driven Marion County Indiana Marion County Public Health Department mental health stigma health care access substance use awareness grief support advocacy outreach information access to care barriers decedent social worker