What we do

Expert resources for behavioral health.

The COE-NF specializes in four behavioral health topics that affect the quality of life for nursing facility residents. We offer easily accessible resources that can help to guide care and improve outcomes.

Serious Mental illness (SMI)

Serious Mental Illness (SMI) are mental disorders that significantly impact a person’s thinking, mood, and/or behavior, and can make it a struggle to work, keep up with school, have healthy relationships, socialize, maintain hygiene and more.

Common SMI diagnoses are:

Bipolar Disorder: brain disorder that causes intense shifts in mood, energy and activity levels  

Major Depressive Disorder (MDD): may include feelings of sadness, hopelessness, anxiety, worthlessness and fatigue 

Schizophrenia: a chronic disorder that causes people to interpret reality abnormally; people may experience hallucinations, delusions and extremely disordered thinking 

Treatment Options:

Often consists of a combination of psychotropic medication and psychotherapy. With early and consistent treatment, it is possible to manage these conditions and lead a meaningful, productive life.

Substance use Disorders (SUD)

A Substance Use Disorder (SUD) is a mental disorder that affects a person’s brain and behavior, leading to a person’s inability to control their use of substances such as legal or illegal drugs, alcohol, or medications. Both legal and illegal substances can be misused. Symptoms can range from moderate to severe, with addiction being the most severe form of SUDs.  

Diagnoses of substance-related disorders fall under the following eight classes of drugs: 

Alcohol

Cannabis: Marijuana

Hallucinogens: PCP, ketamine

Phencyclidine and other hallucinogens: MDMA-ecstasy

Opioids: Heroin, Fentanyl, Oxycodone

Sedatives, hypnotics, or anxiolytic: Benzodiazepines, zolpidem

Stimulants: Amphetamines, cocaine, methamphetamine

Inhalants: Vapors, gas, aerosol sprays, nitrates

Treatment Options:

Options can include residential placement, individual and group therapy, acute care, and medication management. Treatment may include behavioral therapies and medications tailored to an individual’s specific combination of disorders and symptoms, the person’s age, the misused substance and any specific mental disorder(s).
(SAMHSA and Diagnostic and Statistical Manual for Mental Health Fifth Edition)

Co-occurring disorders (COD)

The term “Co-Occurring Disorder” (COD) refers to the condition of having at least one mental disorder and at least one Substance Use Disorder (SUD).  

Common Co-Occurring Disorders and symptoms may include:  

General Anxiety Disorder (GAD): marked by excessive anxiety; intense, frequent and chronic worry  

Depressive disorders: may include feelings of sadness, hopelessness, anxiety, worthlessness and fatigue 

Bipolar Disorder: brain disorder that causes intense shifts in mood, energy and activity levels  

Post-Traumatic Stress Disorder (PTSD): characterized by disturbing or upsetting memories and/or avoidance of uncomfortable situations following a shocking, scary or dangerous event 

Treatment Options:

Options can include residential placement, individual and group therapy, acute care, and medication management. Generally, it is better to treat the SUD and the co-occurring mental disorders together rather than separately.

Serious Emotional Disturbance (SED)

Serious Emotional Disturbance (SED) refers to a diagnosable mental, behavioral, or emotional disorder, in a person under the age of eighteen, that can cause serious problems to daily functioning. The severity of functional impairment varies depending on the age of the child, and the role of the child in the family, school and community.  

Common SED diagnoses in children and youth include: 

Mood Disorders: Major Depressive Disorder, Bipolar Disorder 

Attention Deficit/Hyperactivity Disorder (ADHD): marked by an ongoing pattern of hyperactivity-impulsivity and/or inattention that interferes with functioning or development 

Oppositional Defiant Disorder: marked by persistent acting out that causes serious problems in home, school and with peers 

Conduct Disorder: ongoing pattern of aggression toward others and serious violation of rules and social norms at home, school and with peers 

Post-Traumatic Stress Disorder (PTSD)/Acute Stress Disorder: characterized by disturbing or upsetting memories and/or avoidance of uncomfortable situations following a shocking, scary or dangerous event 

Treatment Options:

Can include psychotherapy, social skills training, medication and service coordination/case management.

How can we help

For any questions on our services, or to find out more about how we can help, please provide some basic information on your facility by clicking on the link below.

Our Newsletter

Get all the latest information from the Center of Excellence for Behavioral Health in Nursing Facilities.

News & Events

COE Newsletter – May 2023

Over the past 20 years, the Substance Abuse and Mental Health Services Administration (SAMHSA) has recognized May as Mental Health Awareness Month. The Mental Health Awareness Month toolkit provides resources to promote conversations, best practices, and materials to support individuals living with a mental illness.

COE Newsletter – April 2023

The month of April which is Alcohol Awareness Month is coming to a close. This month of awareness began in 1987 as a public health program, organized by the National Council on Alcoholism and Drug Dependence (NCADD).

COE Newsletter – March 2023

The COE-NF invites you to register to attend upcoming trainings. Some trainings have seating capacity limits, so early registration is recommended. 

the center of excellence for behavioral health in nursing facilities (COE-NF)

Established by the Substance Abuse and Mental Health Services Administration (SAMHSA), in partnership with the Centers for Medicare and Medicaid Services (CMS), the COE-NF offers Certified Medicare and Medicaid Nursing Facility Staff a centralized resource hub with easy access to trainings, technical assistance and additional resources, at no cost.

What We Do

We help nursing facilities to improve the quality of life and care provided for residents who are experiencing a variety of behavioral health disorders, with a focus on Serious Mental Illness (SMI), Substance Use Disorder (SUD), Co-Occurring Disorders (COD) and Serious Emotional Disturbance (SED).

Who We Help

We provide direct technical assistance, evidence-based training, and resources that are appropriate for every member of your long-term care facility — from those providing day-to-day direct care, to clinical and administrative staff.