Implementing screening and brief intervention in public schools: Feasibility and proof of concept

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Aims: Screening, briefmotivational counseling interventionand referral to treatment (SBIRT) has shown to be effective in reducing substance use and related harms among adolescents in clinical settings but it had not been adapted for use in schools. This translational research study aimed to (a) develop a proof of concept, (b) test the feasibility of conducting SBIRT in two urban New York schools, and (c) examine the economic sustainability. Methods: With the cooperation of the New York OSAS, licensed “health clinics” were createdwithin these schools, equippedwith a computer screening program and a trained substance abuse counselor. The computer presented a standard substance screening; provided tailored prevention information to the student and provided counselor guidance for an immediate, private Motivational Interviewing counseling session. Results: In Spring 2012, 248 students were randomly approached to participate; 100% accepted the screening; 42% of them (n=105) reported substance use (vs. 28% reported in schoolwide, anonymous survey). Importantly, 99% of positively screened students voluntarily accepted onemotivational counseling session and68% returned for additional counseling sessions. The SBIRTprocedure did not interfere with academic activities. Conclusions: The SBIRT was feasible to implement and attractive to students, teachers and administration. We believe the acceptance and participation was due the use of non-school personnel and the private, professional and confidential procedures employed. The data offer clear indication that further effectiveness testing is warranted and potentially valuable. SBIRT, as implemented, has been approved for Medicaid (and some private insurance) reimbursement without co-payment to the parents or students. Economicmodeling demonstrates the current national SBIRT reimbursement rates to be adequate to broadly implement and sustain school-based SBIRT in most mid to largesized schools. Financial support: Phoenix House and Treatment Research Institute.