Abstract
Background Substance abuse and dependence are widely recognized as widespread societal problems, and most people who engage in risky substance use do not recognize it as a problem. The Substance Abuse and Mental Health Services Administration (SAMHSA) launched the Screening, Brief Intervention, and Referral to Treatment (SBIRT) grant program in 2003 to identify, reduce, and prevent problematic use, abuse, and dependence on alcohol and illicit drugs among individuals who would not typically seek treatment. Following the evidence base, SBIRT programs were implemented in general health-care settings, with the aim of integrating behavioral health services in locations that provide an opportunity to identify risky patients and provide them with an appropriate level of treatment. In 2008, SAMHSA sponsored an evaluation of the SBIRT program among its third cohort of grantees. A key focus of the evaluation was to understand the SBIRT workflow process, or the process by which clients interact with health-care personnel to obtain SBIRT services. SBIRT has been implemented in many treatment settings, and each setting has adjusted the workflow process to meet its respective needs. This study focuses on the overall workflow process, adaptations, and key observations in emergency departments and ambulatory clinics.
Highlights
Substance abuse and dependence are widely recognized as widespread societal problems, and most people who engage in risky substance use do not recognize it as a problem
SBIRT programs were implemented in general health-care settings, with the aim of integrating behavioral health services in locations that provide an opportunity to identify risky patients and provide them with an appropriate level of treatment
A key focus of the evaluation was to understand the SBIRT workflow process, or the process by which clients interact with health-care personnel to obtain SBIRT services
Summary
Substance abuse and dependence are widely recognized as widespread societal problems, and most people who engage in risky substance use do not recognize it as a problem. The Substance Abuse and Mental Health Services Administration (SAMHSA) launched the Screening, Brief Intervention, and Referral to Treatment (SBIRT) grant program in 2003 to identify, reduce, and prevent problematic use, abuse, and dependence on alcohol and illicit drugs among individuals who would not typically seek treatment. SBIRT programs were implemented in general health-care settings, with the aim of integrating behavioral health services in locations that provide an opportunity to identify risky patients and provide them with an appropriate level of treatment. Supplemental data were taken from three other sources to gain a deeper understanding on workflow: qualitative data from 170 different interviews with stakeholders, program administrators, practitioners, and local evaluators provided information about workflow in different settings; a review of original and updated official grantee documents to track changes in workflow over time; and estimates of the total number of patients receiving SBIRT services from the Government Performance and Results Act
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