Nurses Taking the Lead in Healthcare Teams: The SBIRT Model - Integrating Evidence-Based Screening, Brief Intervention, Referral and Treatment for Persons at Risk for Substance Use and Mental Disorders

Nurses are often the first line healthcare providers for persons entering a healthcare setting.  There is strong evidence to support a model of screening all persons who enter the healthcare setting for risky behaviors- behaviors that put them at risk for developing a substance abuse or mental disorder.  An evidence based model, promoted by SAMHSA – the U.S. Department of Health and Human Services – Substance Abuse and Mental Health Services Administration, for identifying persons at risk, and then providing active early intervention is SBIRT – Screening, Brief Intervention, and Referral to Treatment.  Nurses can take the lead in championing and integrating models such as the SBIRT – model into many healthcare settings, thereby improving outcomes for those persons at risk of developing substance dependence, or serious mental health disorders.   Nurses can promote evidence-based screening tools, deliver and supervise early interventions such as motivational interviewing, and facilitate referral to specialty substance-abuse, psychiatric treatment when indicated. As critical members of the interdisciplinary healthcare team, they can also play a key role in sustaining the SBIRT protocols, and measuring outcomes in their setting.  Lessons learned from the author’s experiences integrating the SBIRT model into a community primary care clinic will be shared, including barriers to implementation and response from patients and staff once the SBIRT approach was fully part of everyday practice in the clinic. Also experiences teaching this model to nursing students, advanced practice as well as pre-licensure will be shared.  Nursing is one of the key health professions adopting this model, and collaborative learning communities with other healthcare professions are ongoing. Opportunities to join these collaborative initiatives will be shared.