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Screening, Brief Intervention, and Referral to Treatment (SBIRT) Initiative

Screening, Brief Intervention, and Referral to Treatment (SBIRT) Initiative

Substance abuse and addiction are among the most serious and costly health issues in Montana. We are committed to improving access to effective prevention and treatment. By helping to ensure earlier diagnosis and treatment, we hope that this project will help reduce more serious problems down the road, and help contain the public costs of substance abuse as well.

Dr. Aaron Wernham,


The Montana Healthcare Foundation, the Conrad N. Hilton Foundation, and the Montana Department of Public Health and Human Services, partnered to support a new project that will provide earlier diagnosis and treatment of substance misuse in Montana youth and adults. Montana has high rates of substance use disorders, and workforce shortages make it hard for people to access treatment services in many parts of the state. The new project focuses on a practical approach that can be used by primary care practices, mental health centers, and emergency departments. Called “Screening, Brief Intervention and Referral to Treatment,” or “SBIRT,” the approach helps primary care doctors and other providers identify and begin addressing risky alcohol and drug use early-on. Studies show that SBIRT can be a cost-effective way to prevent more serious complications from substance abuse.

The New Hampshire Charitable Foundation has already begun implementing SBIRT in 23 medical facilities across the state of New Hampshire. More than 10,000 young people are projected to receive the substance use screening by mid-2017. The New Hampshire Charitable Foundation created a video to highlight the success of the screenings and brief interventions that doctors are conducting under this project. The video (below) illustrates why SBIRT is working, and how it helps kids and their doctors have the conversations about substance use that keep young people healthy and ultimately save lives.



UCLA Integrated Substance Abuse Programs staff Howard Padwa, Thomas Freese, Beth Rutkowski, and Elizabeth Teshome authored a white paper titled Emerging Lessons Learned from the Implementation of Screening, Brief Intervention, and Referral to Treatment for Adolescents in School-Based Health Settings. In February 2016, a group of Hilton Foundation grantees implementing SBIRT in schools and other national experts in school mental health and substance use prevention and early intervention convened at the Hilton Foundation’s headquarters. The resulting white paper summarizes major themes from convening discussions, and is divided into five sections that cover:

  1. Background information on substance use among adolescents, and the potential benefits of SBIRT services delivered in school settings.
  2. A summary of challenges participants reported having in implementing and sustaining SBIRT for adolescents in school settings.
  3. Strategies that participants found to be helpful when implementing SBIRT and lessons learned that can potentially inform the design and implementation of SBIRT in school settings elsewhere.
  4. Areas where the discussion highlighted unanswered questions about school-based SBIRT program design and implementation.
  5. Potential next steps to help advance both the science and practice of delivering SBIRT services for adolescents in school settings.