Results of the Georgia BASICS SBIRT Initiative J. Aaron Johnson, PhD Gabriel P. Kuperminc, Ph.D Study Committee – November 10, 2015

Georgia BASICS SBIRT Demonstration Project – Implement universal screening in Emergency Departments – Provide Brief Intervention using Motivational Interviewing technique – Additional “in-house” therapy, referral to treatment Settings – Grady Health System (Atlanta) – Medical Center of Central Georgia (Macon)

Urban Emergency Patients Risk – Poverty, housing instability – Lack consistent health care, unmet needs – Behaviors (e.g., alcohol, drug use) linked with health concerns ED visit as “Teachable Moment” – Opportunity to help patients make the connection – Change from blame for poor choices to increased motivation for positive choices

Brief Prescreen: 25% Pos. Patient Enters ED 7% High Risk BI + BT 54% Low- Moderate Risk BI Positive Prescreens receive ASSIST Full Screen 7% Very High Risk BI+ RT BI = Brief Intervention BT = Brief Therapy RT = Referral to Treatment 10% Sample enrolled For 6 month Follow Up Nurse Health Educators 32% Screening Feedback

Georgia BASICS: Services Provided Services Provided Screening/Feedback154,429 Brief Intervention (BI)21,193 BI + Brief Therapy (BT)2,790 BI + Referral to Tx (RT)3,176 Total181,588

Evaluation Screening: Identify Pts. Eligible for Services Screening: Identify Pts. Eligible for Services Brief Intervention Brief Therapy Referral to Treatment Brief Intervention Brief Therapy Referral to Treatment 6-Month Follow Up INTERVENTION GROUP xxx COMPARISON GROUP x0x

Study Sample Comparison Group (N = 1737) SBIRT Group ( N =1170) Years of Education Average Age42 Female34%29% African-American74% Employed Full or Part Time33% Unstably housed/Homeless49%48% Average Monthly Wage$807$571 Notes: (1)SBIRT pts enrolled in study via random selection from those receiving services. (2)Control pts received screening/assessment but no services. (3)6-month follow-ups completed w/ 50% of Control and 65% of SBIRT pts.

Intervention group decreased Substance Use Baseline to 6-mo Follow-up

Greater Decreases in Binge Drinking for SBIRT vs. Control Patients

Mental Health Improvements in Quality of Life

Conclusions REDUCED Alcohol and other Drug use – Similar to findings in other SBIRT studies – Tend to be Larger for SBIRT vs. Comparison – Better Evidence for Effectiveness with Alcohol than other Drugs MORE THAN SUBSTANCE USE – Improved Mental Health may mark greater sense of control, help individuals choose to reduce use of substances

Thanks to SAMHSA, #TI GA Div. Behavioral Health & Developmental Disabilities GSU Colleagues and Students Grady Health System & Medical Center of Central Georgia For more information, contact: J. Aaron Johnson Gabriel Kuperminc