Grant for $8.3 million helps back early prevention, intervention efforts
An innovative new approach to the delivery of early intervention and treatment services for people with substance use disorders, as well as those who are at risk of developing these disorders, will begin early next year at three Wishard Health Services community health centers.

The Substance Abuse and Mental Health Services Administration (SAMHSA), formed by Congress in 1992, has awarded the State of Indiana a five-year grant totaling more than $8.3 million. The project will work to integrate drug and alcohol screening, brief intervention, and referral to treatment (SBIRT) services into the routine standard of care at community health centers and community mental health centers throughout Indiana. Wishard Health Services, Midtown Community Mental Health Center (a division of Wishard), and the Indiana University School of Medicine (IUSM) have been selected to lead the implementation of the program.

"Alcohol and substance abuse remain a challenging problem in our society. A key part of prevention and intervention among those with substance abuse issues, as well as those at risk, is early identification and treatment," Margie Payne, CEO of Midtown Community Mental Health Center and vice president of mental health operations at Wishard Health Services. "The earlier a problem is detected, the more effective prevention efforts may be."

At every appointment at the three community health centers participating in the initial phase of the program, all patients, regardless of race, age or economic status, will be asked about their alcohol and drug usage confidentially, as part of an early intervention approach. Before the program goes live, staff members will be trained in using the screening form regarding, and medical residents will complete Web module trainings and face-to-face workshops regarding SBIRT.

An SBIRT pilot program has been in place in the adult medicine clinic of the Wishard Primary Care Center since late 2010.

SBIRT research has shown that large numbers of individuals at risk of developing serious alcohol or other drug problems may be identified through this type of screening. Interventions such as SBIRT have been found to:
•    Decrease the frequency and severity of drug and alcohol use
•    Reduce the risk of trauma
•    Increase the percentage of patients who enter specialized substance abuse treatment

"A key component is incorporating SBIRT into the routine flow of care in our clinics, and thus increasing patient access to intervention and prevention of harmful substance use and drinking," said Dr. Lisa Harris, CEO and medical director of Wishard Health Services. "At Wishard we place a strong emphasis on primary care and prevention as we know that our biggest opportunity to have a true impact on the health of our community is to help people stay well in the first place."

In addition to decreases in substance abuse, screening and brief interventions have also been associated with fewer hospital days and fewer emergency department visits. Cost-benefit analyses and cost-effectiveness analyses have also demonstrated net cost savings from these interventions.

"SBIRT is an evidence-based solution to this problem of failure to ask," said Ruth Gassman, PhD, director of the Indiana Prevention Resource Center, which is part of Indiana University’s School of Health, Physical Education, and Recreation. "By creating a standard of care in which all patients are asked about substance use, and which has clear protocols for helping those patients based on the results of the screen, SBIRT increases the likelihood that people in need of help, receive that help."                       

The complex effort involves a coalition of health, research, and educational groups, including Wishard Health Services, Midtown Community Mental Health Services, and the Indiana University School of Medicine (IUSM) from Indianapolis, the Indiana Prevention Resource Center (IPRC), Academic Edge, Inc. from Bloomington, and the Family and Social Services Administration (FSSA), Division of Mental Health and Addiction (DMHA). Additional information is available at www.iusbirt.org.