Screening For Unhealthy Alcohol Use At A Tele Mental Health Clinic

Abstract

Problem Statement: Unhealthy alcohol use, which describes a range of risky drinking behaviors including alcohol use disorder (AUD), continues to be among the top priorities of prevention set by the United States Preventive Services Task Force. Guidelines have been established for primary care providers (PCP) to screen for unhealthy alcohol use and offer brief interventions to reduce the risk of harmful drinking. Studies have demonstrated the need for collaborative care, specialized services, and non-abstinence-based modalities to address unhealthy alcohol use. Mental health providers are in a unique position to screen and intervene in cases of unhealthy alcohol use and serve patients at higher risk for substance issues comorbid with mental health concerns. This project will establish a standardized screening and brief intervention process for adult patients at a remote mental health clinic in Hawaii. Purpose: This quality improvement project aims to increase rates of screening for unhealthy alcohol use; increase delivery of brief interventions for unhealthy alcohol use; and familiarize clinicians with methods to screen and counsel patients with psychiatric comorbidities regarding risky and harmful drinking. Methods: We will implement routine screening for new adult patients at a remote mental health clinic using the AUDIT-10 assessment tool. Patients who score within the moderate risk range of unhealthy alcohol use will receive brief interventions consisting of short counseling sessions using motivational interviewing to encourage drinking reduction. Following the delivery of two brief interventions, patients will be re-administered the AUDIT-10 to assess for change in drinking risk. Results: All patients who were eligible to receive the intervention showed a reduction in drinking risk at follow-up assessment, with an average decrease in AUDIT-10 scores of 52.68%. Discussion: The project outcomes support the continued use of SBIRT in mental health settings, which provide the necessary infrastructure for appropriate implementation. Research shows SBIRT programs are effective when skilled specialists are available to deliver brief interventions and more intensive treatment. Conclusion: As SBIRT continues to expand in the primary care setting, greater collaboration is needed between medical providers and behavioral health specialists to expand the continuum of care for substance use issues.