Implementing Adolescent Specific SBIRT in SBHCs

By Letitia D. Winston, Assistant Director of Programs, School-Based Health Alliance

SBIRT in SBHCsNationally, nearly 10 percent of young people ages 12-17 report having used drugs. A  significant amount of those young people are classified as substance abusive or dependent. This growing public health concern should serve as a call to action for school-based health centers (SBHCs). For the past year and a half, the Alliance has provided adolescent-specific SBIRT (Screening, Brief Intervention, Referral to Treatment) training and technical assistance to school-based primary care and behavioral health providers through a pilot project funded by the Conrad N. Hilton Foundation.

Our staff worked with national adolescent substance abuse prevention experts to help 20 providers integrate adolescent-specific SBIRT services into their practice. This resulted in more than 1,500 students being screened for alcohol and substance abuse. Twenty-seven percent of those students ultimately required a brief intervention. This project has demonstrated that, with the right training and resources, school-based health care professionals can make a powerful impact on the lives of young people.

The participants have given positive feedback on the program so far. We’ve heard the training helped them improve how they connect with their students by reframing conversations to address substance use and abuse issues. They also expressed concerns that, after uncovering tremendous need in their schools, they might not be able to support students effectively or with sufficient resources, so connecting with community agencies is critical.

Lessons Learned and Looking Ahead

SBIRT can be an essential tool for communities working to improve population-level health outcomes, and we envision approaches to screening and intervention that reach beyond the clinic walls to address the social determinants of health. We also envision codified SBIRT services in school-based settings that improve adolescent care and serve thousands of middle and high school students annually. We recommend the adoption of SBIRT in SBHCs to:

  • Increase identification of students with a history of substance use
  • Increase the availability and use of SBHC services for health care and substance use intervention
  • Enhance partnerships with school leadership to support alternatives to suspension or restorative justice practices
  • Decrease the use and abuse of substances by adolescents

We are still in the evaluation phase of the project and look to share lessons learned during the past year and a half with the SBHC field at large. Stay tuned for more information. If you have any questions about SBIRT or our pilot project, leave them in the comments below!


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