Key DFM Personnel

Richard Brown, MD, MPH – Principal Investigator
Candace Peterson, PhD – Project Coordinator

Collaborators

Dennis Smith, MPA, Administrator, WI Department of Health Services (DHS)
Joyce Allen, Director, WI DHS, Bureau of Prevention, Treatment and Recovery
Susan Turney, MD – Chief Executive Officer, Wisconsin Medical Society

Funding

Wisconsin Department of Health Services

Summary

The mission of the Wisconsin Initiative to Promote Healthy Lifestyles is to ensure that all patients who receive health care in Wisconsin will routinely and systematically receive Screening, Brief Intervention, and Referral to Treatment (SBIRT) services as a part of their primary health care in Wisconsin.

What is SBIRT?

SBIRT is a comprehensive, integrated, public health approach to the delivery of early intervention and treatment services for persons with and at risk of developing alcohol and other drug disorders. Primary care clinics and physician’s offices, hospitals, emergency departments, trauma centers and community settings provide
opportunities for early intervention with at-risk substance users before more severe consequences occur.

Studies show that SBIRT often identifies and effectively addresses risky behaviors before problems get worse. About 30% of Wisconsinites, ages 12 and up, engage in risky or problem drinking or drug use every month. With so many at risk, a comprehensive, consistent approach is needed. SBIRT especially targets those who are not yet dependent.

Screening quickly assesses the severity of substance use and identifies the appropriate management strategy.

Screening, comprised of a few key questions to each patient once a year as part of any health care visit, and subsequent brief assessment for patients who screen positive, identify alcoholand other drug problems even at the earliest stages.

Brief intervention focuses on increasing patients’ insight and awareness about their use to motivate behavioral change.

Brief intervention, with one to three 20-minute consultations, often elicits substantial change. More extended motivational interventions can help ambivalent patients or those who need more support.

Referral to treatment provides those identified as needing more extensive treatment with access to specialty care.

Referral to treatment for more intensive needs includes outpatient or residential care. For patients who cannot or will not obtain treatment, primary care based pharmacotherapy and support can help.

Why is SBIRT needed? Wisconsin’s rates of risky and problem drinking are among the highest in the nation. The economic toll on our health care, social services and criminal justice systems exceeds $5 billion annually.

The WIPHL program’s initial focus is unhealthy drinking and drug use, as required by its current funding source, but in coming years the program will seek and create opportunities to expand more meaningfully into other health lifestyle areas. These could include such lifestyle areas as tobacco use, nutrition and exercise, depression and other mental health disorders, domestic violence, and unsafe sexual practices.

The program is partnering with primary care clinics around the state to provide evidence-based, cost-efficient screening, brief intervention, and referral to treatment services to help patients make positive changes. These services will be non-judgmental, culturally sensitive, and engage patients as the agents of positive change in their lives.

The SBIRT project aims to

  • Inform and support health care professionals, employers, insurance providers, purchasers, policymakers, patients, and citizens in their efforts to make SBIRT services as widely available and easy to access as possible.
  • Identify organizations that support SBIRT, including the Wisconsin Medical Society, Wisconsin Manufacturers & Commerce, Wisconsin Hospital Association, Wisconsin Primary Health Care Association, the Menominee Indian Tribe of Wisconsin, Wisconsin Council on Children and Families, and Addiction Resources Council, Inc.
  • Offer training, support, and technical assistance to ensure high-quality, cost-effective SBIRT implementation
  • Identify best practices and models to facilitate the use of SBIRT for public and private coverage