Substance Use Prevention in SBHC

About the Substance Use Prevention in SBHC Initiative

Children's Aid Society: A student meets with a provider.

A student meets with a provider.

The 2016 Surgeon General’s Report on Alcohol, Drugs, and Health, titled “Facing Addiction in America,” is a call to action for the school-based health care (SBHC) field and others. More than 90 percent of individuals who experience a substance use disorder as an adult began their use before the age of 18. Assessing risk and protective factors is a service provided by all SBHCs, presenting the opportunity to develop and enhance substance use prevention and early intervention, delaying the onset of use, and decreasing the likelihood of addiction as an adult. Actively screening and intervening with youth will lead to better outcomes academically and overall health and well-being.

Project Description

In 2015, the School-Based Health Alliance received funding from the Conrad N. Hilton Foundation to conduct a two-year pilot project (SBIRT Phase I) to train a group of school-based health providers in screening, brief intervention, and referral to treatment (SBIRT) methods and test the feasibility of this approach in a school-based setting.

In 2017, once again with funding from the Conrad N. Hilton Foundation, the Alliance began the second phase of this initiative. During SBIRT Phase II, lessons learned from the pilot project will be used to expand the adoption and use of SBIRT within the SBHC field with enhanced resources to overcome electronic health record challenges.

The new two-year project will use two strategies: (1) a learning collaborative to engage additional SBHC sites to use SBIRT as a vehicle to identify, prevent, and reduce substance use and depression and (2) a new focus on working with educational partners to develop alternatives to discipline policies that may include referrals to the SBHC site for further assessment to get at the multifaceted issues that could be at the root of the disciplinary action.

Project Updates

Alliance Releases RFA for SBIRT Phase II (Spring 2017)

Through the generous funding of the Conrad N. Hilton Foundation, the Alliance is launching a learning collaborative called Screening, Brief Intervention, and Referral to Treatment (SBIRT) in School-Based Health Centers Phase II to prevent, identify, and reduce substance use and depression in middle and high school age youth. SBIRT Phase II addresses two of the key topical areas for technical assistance requests from the field:  depression and substance use.

Read more about the RFA.

SBIRT Phase II will fund up to four SBHC sponsor organizations, each identifying up to three SBHC sites, for the national learning collaborative (up to 12 sites total.) The funding will cover on-site training (up to $2,000 per sponsoring agency), stipends for sponsoring agencies ($5,000 per site), evaluation support, electronic health record (EHR) improvements (up to $10,000 per sponsoring agency EHR), travel to School-Based Health Alliance 2018 convention, and ongoing technical assistance and training. The deadline for application is June 30, 2017. For more information, download the full RFA.

Lessons Learned from SBIRT Phase I (Fall 2016)

During Phase I of the Screening, Brief Intervention, and Referral to Treatment (SBIRT) in School-Based Health Centers Phase I pilot project, the Alliance learned that, with support and encouragement, school-based health centers can and will incorporate SBIRT into their workflow. Providers said that using SBIRT increased their awareness of substance use and other mental health issues in their schools.

Read more about Lessons Learned.

The Alliance also found that collaborations between several school-based health centers and school administrations successfully incorporated the SBIRT pilot project into alternatives to discipline, such as sending students suspected of behavioral issues due to substance use to the school-based health center for screening rather than out of school; and using Teen Intervene as an in-school suspension program.

Sites Selected for SBIRT Phase I (Winter 2015)

The Alliance would like to recognize the following school-based health care programs for being selected to participate in Phase I of the Screening, Brief Intervention, and Referral to Treatment (SBIRT) pilot project. Each program will receive training in SBIRT methods and test the feasibility of this approach in their school-based setting.

Cohort I
Beaverton High SBHC, Beaverton, OR
Merlo High School SBHC, Beaverton, OR
Skyline High School/Life Academy, Oakland, CA
United for Success Middle School, Oakland, CA
Madison Middle School Health Center, Oakland, CA

Cohort II
Coolidge High SBHC, Washington, DC
Dunbar High, Washington, DC
St. Francis Academy SBHC, Baltimore, MD
Auburn Gresham, Chicago, IL

What Is SBIRT? (Fall 2015)

Developed by the Substance Abuse and Mental Health Services Administration, Screening, Brief Intervention, and Referral to Treatment (SBIRT) is an evidence-based approach used to identify, reduce, and prevent substance use, abuse, and dependence. Grounded in motivational interviewing, the SBIRT model includes the following components that are being adopted by participating sites:

Read more about the SBIRT Approach.
  • Screening: Providers use the CRAFFT tool, a six-question behavioral health screening method for use with children and adolescents, to identifying when a young person is struggling with substance abuse issues.
  • Brief Intervention: When a substance abuse disorder has been identified, providers conduct brief interventions with students through the CRAFFT screening process as mid- to high-risk substance users. Providers use motivational interviewing to help students make their own decision to abstain from substance use.
  • Referral to Treatment: Providers appropriately refer students to treatment for adolescents demonstrating substance abuse disorders requiring care beyond that of a brief intervention.


For more information on SBIRT, visit our Health and Learning section.