SBIRT: Screening, Brief Intervention, Referral and Treatment (InSight)

SBIRT is a 5-year $17.5 million dollar Targeted Capacity Expansion Grant funded by the Center for Substance Abuse Treatment to expand treatment capacity. Seven grant recipients across the nation are testing models in the health care setting. The grantees focus on stopping the initiation of alcohol, tobacco and other drug use, intervening early with nondependent users to stop inappropriate use, and improving treatment delivery to achieve significant and sustained recovery for those who are dependent on alcohol, tobacco and other drugs.

This project is located in eight Harris County Hospital District locations, including Ben Taub General Hospital (emergency department and other units), four community clinics, and three school-based clinics. This project utilizes general healthcare staff and a specially-trained multidisciplinary SBIRT team to screen and serve over 44,000 patients. It incorporates new processes for ATOD screening and treatment in the healthcare setting to establish permanent systems change. Staff are encouraging primary care physicians to diagnose for substance abuse when presented with early symptoms, to refer substance abusers to treatment, and to intervene with problem drinkers by providing two 15-minute sessions addressing drinking problems.

SBIRT services include:

Screening--Initial ATOD screens [by generalists] to identify at-risk persons and overall prevalence in county hospital district.
Brief Advice--one-time intervention for short consultation and literature
Brief Intervention-one to five short motivational sessions to encourage and promote healthy behaviors.
Brief Treatment--one to twelve sessions of substance use intervention (MET, CBT, etc.) provided by specially-trained substance abuse counselors at the Houston Council on Alcohol and Drug Abuse.
Referral to Treatment--for dependent users to receive specialized services and case management from providers in the county.

SBIRT in Texas is named the InSight program. More information on the program may be seen at www.insightforhealth.com which also contains useful links and videos on the topic.

The Partners and Collaborators in InSight:

The Substance Abuse and Mental Health Services Administration provides funding through the Center for Substance Abuse Treatment.

Texas Department of State Health Services administers the cooperative agreement grant.

Harris County Hospital District operates InSight at hospitals and clinics, providing screening, brief intervention, referral, and primary care services as a part of routine medical care.

The Council on Alcohol and Drugs Houston provides outpatient Brief Treatment (a series of individualized counseling sessions), referral to outpatient and inpatient treatment services through a unique arrangement with DSHS, and manages patient follow-up.

Baylor College of Medicine provides medical leadership, generalist training and provider support, and content expertise.

University of Texas at Austin provides training, coaching, and provider support for InSight staff. UT also conducts program evaluation, data management, and provides project reports.

Screening, Brief Intervention and Referral to Treatment--a presentation by

Gail D'Onofrio, MD, Chief and Associate Professor, Section of Emergency Medicine, Yale University School of Medicine

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Addiction Research Institute
Center for Social Work Research
School of Social Work
University of Texas at Austin
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