Bridging the gap: A low-barrier co-occurring diagnosis navigation model in a consumer-run drop-in center

Co-occurring mental health and substance use challenges represent one of the most difficult gaps in community behavioral health care. Individuals with overlapping needs often face stigma, transportation barriers, fragmented systems, complex intake processes, and distrust of traditional clinical settings. As a result, many people who need support are least likely to successfully engage through standard appointment-based systems.

The H.O.P.E. Drop-In Center in Altoona, Pennsylvania developed the Co-occurring Diagnosis Navigator model to address this gap from inside a trusted, consumer-run, low-barrier setting. Rather than requiring participants to first enter a formal clinical environment, the model brings recovery navigation, peer support, and warm handoff capacity into a voluntary drop-in center where relationships are built through repeated, informal contact. H.O.P.E. requires no appointment, insurance, or identification for general drop-in engagement, allowing trust to develop before a participant is asked to navigate more formal systems.

The Co-occurring Diagnosis Navigator role is designed to support individuals who experience recovery needs, mental health needs, and practical life barriers at the same time. The Navigator provides non-clinical support, recovery planning, resource navigation, referral assistance, appointment preparation, follow-up, and warm handoffs to appropriate community providers. This approach recognizes that readiness often develops through relationship, consistency, and safety rather than through a single referral or intake attempt.

A pre-launch community needs assessment at H.O.P.E. demonstrated strong participant interest in this model. The survey achieved a 66% response rate among attendees, reflecting meaningful engagement from a population often hesitant to participate in formal assessments. Among respondents, 74% reported they would use Navigator services if offered within the familiar drop-in setting, while an additional 20% recognized the value of the service for others in the community. This resulted in a 94% overall endorsement of the proposed model.

This presentation will describe the development of H.O.P.E.'s Co-occurring Diagnosis Navigator model, including the role design, low-barrier engagement strategy, warm handoff process, sustainability planning, and early community response. The model demonstrates how consumer-run settings can serve as practical access points for co-occurring support without compromising trust, autonomy, or participant choice. By embedding structured recovery navigation into a safe, familiar environment, H.O.P.E. offers a replicable approach for improving engagement among individuals who often fall between mental health, substance use, and social service systems.