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START is an in-home service for older adults ages 60 and above who have a serious mental illness and misuse substances such as alcohol, recreational drugs, over the counter and prescription medications. START serves older adults who are unable to access traditional services geared toward drug and alcohol abuse. Services include engagement, brief intervention, mental health and substance abuse counseling and education, coordination with health care providers, case management, information and linkage to community services and inpatient treatment programs.