Screening, Brief Intervention and Referral to Treatment (SBIRT): rationale, program overview and cross‐site evaluation

Abstract

Treatment (SAMHSA, CSAT) has awarded 32 Screening, Brief Intervention and Referral to Treatment (SBIRT) grants to states, territories and tribal organizations to enhance services for persons with, or at risk for, substance use disorders. The grants supported an expansion of the continuum of care to include screening, brief intervention, brief treatment and referral to treatment in general medical and community settings. This paper describes the SAMHSA SBIRT program in the context of the scientific research that motivated its development, as well as the two cross-site evaluations that are the subject of subsequent papers in this Supplement. Methods A narrative review of research evidence pertaining to SBIRT and of the cross-site evaluation design that made it possible to determine whether the SAMHSA SBIRT grant program achieved its intended aims. The 11 programs within the two cohorts of grant recipients that were the subject of the cross-site evaluations are described in terms of SBIRT service components, performance sites, providers, management structure/activities and patient/client characteristics. Conclusion The US SAMHSA SBIRT program is an effective way to introduce a variety of new services that extend the continuum of care for substance-involved individuals, ranging from early intervention with non-dependent substance users to referral of more serious cases to specialized substance abuse treatment.

Screening, Brief Intervention and Referral to Treatment: implications of SAMHSA's SBIRT initiative for substance abuse policy and practice

“…The economic evaluation estimated the costs of delivering SBIRT services. Finally, a systemwide analysis drew upon the three evaluation components and other data sources to evaluate the effects of the SAMHSA SBIRT grant program on the treatment system as a whole [21].…”

“…As described by Bray et al [21], SBIRT programs in the two evaluated SAMHSA cohorts screened more than 1 million patients (cohort 1 = 528 036; cohort 3 = 489.396). More than one in five (22.4 %) screened positive in cohort 1 and slightly more than one in 10 (11.1%) did so in cohort 3.…”

Screening, brief intervention and referral to treatment (SBIRT): implementation barriers, facilitators and model migration

“…To increase its adoption in health-care settings in the United States, the SAMHSA launched a major grant program in 2003 to implement SBIRT for alcohol and other substance use. The first cohort of grant recipients included six states (California, Illinois, New Mexico, Pennsylvania, Texas, Washington) and two tribal organizations in Alaska (see [5] for a more complete description of the individual programs).…”

“…Secondly, grant recipients were given considerable latitude in choosing settings, service providers, screening and other instruments and in developing referral options for high-risk individuals that would have to include both brief treatment (BT) (a limited series of out-patient sessions, each approximately 50-60 minutes in duration) and traditional specialty care for substance use disorders. Each of the seven SAMHSA programs implemented SBIRT services in multiple settings that included emergency departments and trauma centers, in-patient hospital services and ambulatory clinics (see [5], this Supplement). Historically, SBI programs have tended to recruit medical staff to deliver services (in-house generalist model); however, many SAMHSA SBIRT service delivery sites hired specially trained health educators (in-house specialist model), and others contracted services through an independent agency specializing in addiction treatment (contracted specialist model).…”

Incorporating services for common mental disorders and substance use disorders for people living with HIV along the HIV treatment cascade

“…In a community-based setting with screening performed by lay health workers or trained peers, a brief intervention comprising psychosocial support and first aid for CMDs can be provided [65]. For SUDs, a brief intervention with referral to treatment can be provided [66]. An important outcome for all tested for HIV infection is connection and access to health care.…”