Youth Screening, Brief Intervention, and Referral to Treatment (YSBIRT) is an evidence-based practice to prevent and reduce risky substance use among adolescents ages 12 to 18.
YSBIRT.org aims to equip the primary care field with the resources and support necessary to implement SBIRT in their practices. It was born out of a partnership between the National Council for Mental Wellbeing (National Council) and the Conrad N. Hilton Foundation.
- Background information on the Facilitating Change for Excellence in SBIRT (FaCES), an initiative executed by the National Council with funding from the Conrad N. Hilton Foundation to develop an evidence-informed, standardized, and flexible approach to adolescent SBIRT implementation in primary care.
- An implementation guide, or change package, for YSBIRT in primary care. The change package comprises 11 specific recommendations – or change concepts – that marry high-level implementation guidance with the actual operational changes required for effective practice transformation. It also includes benchmarks as a way to measure implementation progress.
- Training opportunities to enhance SBIRT education and readiness to implement within primary care.
- YSBIRT Resource Hub, which provides access to the most current tools and resources.
Turning the Heat Down on Adolescent Substance Use
All youth experience social determinants of health, or conditions in which they are born, grow, and live. These conditions create a set of protective factors that decrease the likelihood and risk factors that increase the likelihood for engaging in risky substance use. Each youth has a set of protective and/or risk factors unique to their personal circumstances. These circumstances are like a pot of water on a stove, where each risk factor turns up the heat, making it more likely for the pot to boil over, and for the youth to engage in risky substance use. Some examples of risk factors include economic instability, limited access to healthcare, and having a parent with a substance use disorder.
When adolescents experiment with alcohol and other drugs, it can heat up and boil over into a bigger problem. By creating environments that keep the heat down for adolescents, we can prevent substance use from boiling over into a bigger problem.
Adolescence represents both a critical at-risk period for substance use initiation as well as an opportune time to intervene and prevent behaviors from developing into more acute health problems. Not all adolescents who experiment with drugs and alcohol will develop a substance use disorder; however, all psychoactive substances have negative effects on the still-developing adolescent brain. Substance use in youth has been shown to contribute to academic underachievement, interruption of the natural course of brain maturation, and is a predictor of substance use disorders in adulthood.
Healthcare professionals have a responsibility to do their part to turn the heat down on adolescent substance use by educating youth, identifying risky use, and intervening early. Systematic screening can lead to beneficial health outcomes and reduce future misuse.
Screening, Brief Intervention and Referral to Treatment (SBIRT) is an integrated and comprehensive, evidence-based, early intervention implemented in primary care settings to identify, reduce, and prevent alcohol and drug use, misuse, and dependence. It is NOT another task that will take a significant amount of time to carry out; rather it is an intervention that can and should be incorporated into existing processes and procedures in the primary care setting to facilitate effective and necessary care for adolescents.
The SBIRT process includes:
- SCREENING to identify an adolescent’s place on a spectrum from non-use to substance use in order to deliver an appropriate response.
- BRIEF INTERVENTION (BI) to raise patient awareness of risks, elicit internal motivation for change, and help set behavior-change goals.
- REFERRAL TO TREATMENT (RT) to facilitate access to and engagement in specialized services and coordinated care for patients at highest risk.
There are several key reasons for why SBIRT should be considered. These include:
- Substance use’s negative impact on overall health.
- SBIRT’s support of a full clinical picture of a patient, rather than compartmentalized care.
- Early substance use interventions can prevent development of more severe substance use disorders.
- Protocol standardization supports substance use identification.
- You don’t have to be a specialist. SBIRT can be integrated into routine care and fits into workflows.
- Cost savings and increased accountability from a range of payers.
“It was a joy to see the medical side and behavioral health side participating and taking ownership of the project. Success also included the results of helping those that identified usage, providing the brief interventions and the help/referrals needed for treatment.”
“We have had parents thank our clinical staff for asking the questions about substance use as well as their ability to encourage their teens to open up. Parents have expressed gratitude towards the providers for addressing these issues and working with the teens to develop a safety plan.”
“The implementation of SBIRT has changed and positively shifted the organizational culture within CHI for the better, as we continue to provide integrated behavioral health and primary care services to our patients in the South Florida region.”
“Many of us have realized the importance of administering the S2BI at every session, which gives these adolescents more opportunities to open up, even if they denied use before, and to ask questions.”