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INTEGRATING SUICIDE PREVENTION INTO THE SBIRT MODEL

HOSTED BY:ADOLESCENT SBIRT PROJECT, NORC at THE UNIVERSITY OF CHICAGO, and

THE BIG SBIRT INITIATIVE

Webinar Moderator

Tracy McPherson, PhD Senior Research ScientistPublic Health DepartmentNORC at the University of Chicago 4350 East West Highway 8th Floor, Bethesda, MD 20814 esap1234@gmail.com

Produced in Partnership…

www.sbirt.webs.com sbirtteam@norc.org

2018-2019 SBIRT Webinar Series

¨ Adolescent Substance Use Screening Tools: A Review of Brief Validated Tools

¨ Integrating Suicide Prevention into the SBIRT Model

¨ Primary Care Professionals' Readiness to Integrate Behavioral Health: A National Survey

¨ Adolescents, Young Adults and Opioid Use: When Is It a Problem? What to Do?

¨ Adolescent Substance Use: Contemporary Trends in Prevention and Treatment

¨ Integrating Adolescent SBIRT Education into Health Professional Training: Findings from A National Effort to Prepare the Next Workforce

https://sbirt.webs.com/webinars

Download this flyer from our website!

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

is a comprehensive, integrated, public health approach to the delivery of early intervention for individuals with risky alcohol and drug use, and the timely referral to more intensive substance abuse treatment for those who have substance abuse disorders.www.sbirt.webs.com/webinars

SBIRTWEBINARSERIESLIVE EVENTS and ON DEMAND RECORDINGS

More info, descriptions, learning objectives, PowerPoint slides, presenter biographies, and webinar recordings:

www.sbirt.webs.com/webinars

Produced in partnership with the Adolescent SBIRT Project, NORC at the University of Chicago, and the BIG Initiative, and sponsored by the Conrad N. Hilton Foundation.

ON DEMAND WEBINAR TOPICSWATCH ANY ON DEMAND RECORDING FOR FREE AT YOUR CONVENIENCE! • Intro • Adolescents • Clinical Training • College Students • Implementation• Motivational Interviewing • Nurses • Opioids • Primary Care • Screening Tools• Social Workers • Suicide • Teens • Trends • Vulnerable Populations • Young Adults

• Free live events held several times per month and 24/7 on demand viewing• Watch from work, home, or on the go!• Only need a computer/internet connection or a smartphone (compatible with PC,

Mac, iPad, iPhone, Android)• Expert presenters from across the country• Free Certificates of Attendance for everyone• Ideal for nurses, social workers, mental health counselors, substance use

professionals, medical professionals, professional counselors, psychologists, employee assistance professionals, and other helping professionals that are interested in learning about SBIRT

• Use with clinical supervision or watch together with your colleagues

All webinars held throughout the month onThursdays @ 1pm ET (12CT/11MT/10PT)

2018-2019 ScheduleAdolescent Substance Use Screening: A Review of Brief Validated ToolsDECEMBER

2018

6

Integrating Suicide Preventioninto the SBIRT Model

Primary Care Professionals' Readiness to Integrate Behavioral Health:A National Survey

JANUARY2019

24

FEBRUARY2019

28

Adolescents, Young Adults and Opioid Use: When Is It a Problem? What to Do?MARCH

2019

14

APRIL2019

18 Adolescent Substance Use: Contemporary Trends in Prevention and Treatment

MAY2019

23 Integrating Adolescent SBIRT Education into Health Professional Training: Findings from A National Effort to Prepare the Next Workforce.

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Access Materials

https://sbirt.webs.com/suicide-sbirt

¨ PowerPoint Slides

¨ Materials and Resources

¨ On Demand Access 24/7

¨ Certificate of Attendance

¨ Evaluation Survey

Ask Questions

Ask questions and modify Audio Settings through the “Questions” pane of your GoToWebinar Control Panel on your computer or mobile device.

Webinar Presenter

Brett Harris, DrPHClinical Assistant ProfessorUniversity at Albany School of Public Healthbharris@albany.edu

Poll Question #1

¨ What is your primary field?¤ Substance use

¤ Suicide prevention

¤ Other

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Source: CDC Vital Statistics Reports, 2003-2016

Percent Change in Age-Adjusted Death Rates since 2003 by Cause of Death, 2003-2016

-50%

0%

50%

100%

150%

200%

2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016

He art d is ease Can ce r S tro ke Dru g Ov e rdose Al l -cau se

Source: CDC Vital Statistics Reports, 2003-2016

Percent Change in Age-Adjusted Death Rates since 2003 by Cause of Death, 2003-2016

-50%

0%

50%

100%

150%

200%

2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016

S ui cide He art d is ease Canc e r S tro ke Dru g Ov er dose Al l -caus e

Self-Injury Mortality

¨ 70,237 drug overdoses and 47,101 suicides in 2017¨ Number of suicides are underestimated ¨ Suicide prevention as substance use/opioid overdose

prevention

Rocket et al., 2018; Oquendo et al., 2018

Demographic Groups and Statistical Trends

Suicide as a Public Health Problem

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Age and Gender

22.6

27.6 27.430.2 29.8

26.2

35.8

50.6

5.8 7.1 8.510.4 8.9

6.24.3 3.5

0

10

20

30

40

50

60

15-24 25-34 35-44 45-54 55-64 65-74 75-84 85+

Crud

e ra

te p

er 1

00,0

00

Suicide death rate by age and gender, US, 2017

Male Fe male

Source: CDC Wonderhttps://wonder.cdc.gov/controller/datarequest/D76;jsessionid=5A36BC05F1C9647D83F98CB3C6C0613E

22.0%

78.0%

Suicide Deaths by Gender, US, 2017

Fema le Ma le

Age and Gender: Self-Harm

459.7

299.6

225.5201.8 194.2

164.5183.2

156.0

118.1

69.252.9

36.422.8 28.7

16.4

0

50

100

150

200

250

300

350

400

450

500

15-19 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-74 75-79 80-84 85+

Rate

per

100

,000

Rate of self-harm by age, US, 2016

129.1

192.9

0

50

100

150

200

250

Age-

adju

sted

rate

per

100

,000

Rate of self-harm by gender, US, 2016

M ale F em ale

Source: CDC WISQARShttps://webappa.cdc.gov/sasweb/ncipc/nfirates.html

Age and Race/Ethnicity

15.4

19.520.8

23.522.0

17.4

20.122.0

10.311.9

9.2

7.2

5.1 4.5 4.2

22.7

25.9

18.3

15.5

8.6

11.5

8.46.5

7.6 7.17.9 7.7

12.8

8.79.9

8.5 8.2 7.55.9

8.19.4

0

5

10

15

20

25

30

15-24 25-34 35-44 45-54 55-64 65-74 75-84 85+

Age-

adju

sted

rate

per

100

,000

Age-adjusted suicide death rate by age and race/ethnicity, US, 2017

Wh i te B lac k Ame ri can In d ian / Alas ka Nati ve Asian/ P aci fi c I slande r Hi spani c

Source: CDC Wonderhttps://wonder.cdc.gov/controller/datarequest/D76;jsessionid=5A36BC05F1C9647D83F98CB3C6C0613E

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Means and Gender

9.0%

27.7%

56.1%

7.2%

31.4%27.9%

31.2%

9.5%

0%

10%

20%

30%

40%

50%

60%

P oi so n in g S uff oc a tio n F ire arm O the r

Suicide Deaths by Means and Gender, US, 2017

M ale F em ale

13.9%

27.8%50.6%

7.7%

Suicide Deaths by Means, US, 2017

Pois oning Suf foca tion Fire ar m Ot herSource: CDC Wonderhttps://wonder.cdc.gov/controller/datarequest/D76;jsessionid=5A36BC05F1C9647D83F98CB3C6C0613E

Urban vs. Rural Classification

Source: NCHS Data Brief No. 330, Nov. 2018 https://www.cdc.gov/nchs/data/databriefs/db330-h.pdf

Means by Urban vs. Rural Classification

13.2

1.1

6.3

3.9

1.9

19.1

0.8

10.9

5.3

2.0

0 5 10 15 20 25

TOTAL

Other

Firearm

Suffocation

Poisoning

Age-adjusted suicide rate per 100,000

Age-adjusted suicide rate by geography and means, US, 2017

Rur al U rb an/Sub urb anSource: CDC Wonderhttps://wonder.cdc.gov/controller/datarequest/D76;jsessionid=5A36BC05F1C9647D83F98CB3C6C0613E

Suicidal Thoughts/Behaviors among Youth, by Sexual Orientation

7.4%

13.6%

17.2%

31.5%

5.4%

10.4%

13.3%

27.5%

18.6%

33.2%

41.4%

53.1%

0% 10% 20% 30% 40% 50% 60%

Att empted Suic id e

Made a Plan

Seriously Consider ed Attempting Suicide

Felt Sad or H opeless

Depressed mood, suicidal thoughts and behaviors in the past 12 months by sexual orientation, US high school students, 2017

G ay o r Le sb ian He ter ose x ua l T ota l

Source: CDC Youth Risk Behavior Survey https://www.cdc.gov/healthyyouth/data/yrbs/results.htm

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Circumstances Contributing to Suicide

Source: CDC Vital Signs, 2018, https://www.cdc.gov/vitalsigns/pdf/vs-0618-suicide-H.pdf

Intersection of Substance Use and Suicide

Drug Overdoses Fueled by Opioids

¨ 67.8% of drug overdoses involved opioids in 2017¨ Between 2016 and 2017:

¤ Overdose deaths involving synthetic opioids (other than methadone) increased 45.2%

¤ Cocaine-related overdose deaths increased 34.4%¤ Psychostimulant-related overdose deaths increased 33.3%

¤ Stable for prescription opioids and heroin

¨ Injection drug use increases risk of suicide fourteen-fold

*Illicitly manufactured fentanyl mixed into other

drugs likely contributing to increases in overdoses

Scholl, L., Seth, P., Kariisa, M., Wilson, N., & Baldwin, G. (2018). Drug and opioid-involved overdose deaths – United States, 2013-2017. Morbidity and Mortality Weekly Report. Retrieved from https://www.cdc.gov/mmwr/volumes/67/wr/mm675152e1.htm?s_cid=mm675152e1_w. Substance Abuse and Mental Health Services Administration. (2016). Substance use and Suicide: A nexus requiring a public health approach. Retrieved from http://store.samhsa.gov/shin/content//SMA16-4935/SMA16-4935.pdf.

Substance Misuse and Suicide

• Substance use is the 2nd most frequent risk factor for suicide• Alcohol misuse or dependence increases risk tenfold

• Alcohol intoxication in 30-40% of attempts

Substance Abuse and Mental Health Services Administration. (2016). Substance use and Suicide: A nexus requiring a public health approach. Retrieved from http://store.samhsa.gov/shin/content//SMA16-4935/SMA16-4935.pdf.

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Connection between Substance Use and Suicide

¨ Disinhibition during intoxication¨ Increasing depressed mood¨ Alcohol increases proximal risk

¤ Increases psychological distress

¤ Increases aggressiveness¤ Propels ideation into action through suicide-specific alcohol

expectancies

¤ Constricts cognition, impairing the generation and implementation of alternative coping strategies

Substance Abuse and Mental Health Services Administration. (2016). Substance use and Suicide: A nexus requiring a public health approach. Retrieved from http://store.samhsa.gov/shin/content//SMA16-4935/SMA16-4935.pdf.

Call to Action

http://store.samhsa.gov/shin/content//SMA16-4935/SMA16-4935.pdf

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

Preventing and Reducing Alcohol and Drug Use

~ half of US population 12+ are current drinkersSource: SAMHSA National Survey on Drug Use and Health, 2017 https://www.samhsa.gov/data/sites/default/files/NSDUH-FFR1-2016/NSDUH-FFR1-2016.pdf

Alcohol Consumption in the US

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Drug Use in the US

¨ 7.9% of adolescents 12-17 report illicit drug use in the past 30 days

Source: SAMHSA National Survey on Drug Use and Health, 2017 https://www.samhsa.gov/data/sites/default/files/NSDUH-FFR1-2016/NSDUH-FFR1-2016.pdf

Addressing Problem Substance Use

¨ Historically, the focus has been on¤ Prevention: prevent abstainers from initiating use¤ Treatment: for those with substance use disorders (SUDs) with the goal of

abstinence

¨ What about for everyone else?¤ Most who drink or use drugs do not have an SUD and do not seek treatment¤ Can benefit from early intervention outside of SUD treatment settings to reduce

risky use before more severe problems occur

The Current ModelA Continuum of Substance Use

Abstinence

Addiction

Responsible Use

Poll Question #2

¨ How familiar are you with SBIRT?¤ Not at all familiar

¤ I know a little bit about it but could use some more background

¤ Very familiar

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What is SBIRT?

An evidence-based prevention and early intervention model to address the full continuum of substance use • Screening• Brief Intervention

• Referral to Treatment

• Goal: Identification of at-risk substance users in non-SUD treatment settings and provision of appropriate services

The SBIRT Model – A Continuum of Substance Use

Abstinence

Experimental Use

Social Use

Binge Use

Problem Use

Substance Use

Disorder

5%

20%

75%

Substance Use Disorder

Low Risk orAbstinence

No Intervention or screening and Feedback

Brief Intervention and Referral for additional Services

Source: Babor, T.F. & Higgins-Biddle, J.C. (2001). Brief intervention for hazardous and harmful drinking: a manual for use in primary care. World Health Organization. Retrieved from http://apps.who.int/iris/bitstream/10665/67210/1/WHO_MSD_MSB_01.6b.pdf.

Integrating Suicide Prevention into the SBIRT Model

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Poll Question #3

¨ Have you ever had a patient with suicidal thoughts or behaviors?¤ No

¤ Yes, one time

¤ Yes, more than one

¤ I don’t see patients

Screening• Pre-screening

• AUDIT-C (alcohol)

• DAST-1 (drugs)• Add PHQ-3 (depression and suicide)

• Screening using standardized tools• AUDIT• DAST-10

• CRAFFT 2.0 for adolescents (alcohol and drugs)• PHQ-9

• Add C-SSRS for a yes response to the last question of the PHQ-3/PHQ-9• C-SSRS or ASQ may be used for adolescents

n Screen followed by C-SSRS assessment version if necessary

PHQ-3

Over the last 2 weeks, how often have you been bothered by the following problems?1. Little interest or pleasure in doing things

2. Feeling down, depressed, or hopeless3. Thoughts that you would be better off dead or of hurting yourself

in some way¤ Trigger C-SSRS or ASQ

PHQ-9: Kroenke et al., 2001

Columbia-Suicide Severity Rating Scale (C-SSRS)

Source: Columbia Lighthouse Project

http://cssrs.columbia.edu/

For use with both adolescents and

adults

This version copied from a pocket

card designed for adolescents

Method

Intent

Plan + Intent

Lifetime vs. recent

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Using and Interpreting the C-SSRS

Question Intent: Thoughts and Behaviors

Response

Q1. Wish to be dead Behavioral Health Referral

Q2. Suicidal thoughts Behavioral Health Referral

Q3. Suicidal thoughts with method (w/o specific plan or intent)

Behavioral Health Consult (Psychiatric Nurse/Social Worker) and consider Patient Safety Precautions

Q4. Suicidal intent (without specific plan)

Behavioral Health Consultation and Patient Safety Precautions

Q5. Suicidal intent with specific plan Behavioral Health Consultation and Patient Safety Precautions

Q6. Suicidal behavior not within the past 3 months

Behavioral Health Consult (Psychiatric Nurse/Social Worker) and consider Patient Safety Precautions

Q6. Suicidal behavior within the past 3 months

Behavioral Health Consultation and Patient Safety Precautions

Source: National Institute of Mental Health https://www.nimh.nih.gov/labs-at-nimh/asq-toolkit-materials/asq-tool/screening-tool_155867.pdf

Designed for use

with adolescents

Even patients who screen negative for suicide risk should be provided with the Lifeline and Crisis Text Line numbers as

well as counseling on two specific changes or events that could quickly increase risk

Brief Intervention

¨ Brief intervention using the Brief Negotiated Interview (BNI)• Build rapport• Pros and cons• Information and feedback (elicit-provide-elicit)• Readiness ruler• Action plan

¨ Safety Planning Intervention (SPI) for patient at-risk for suicide¤ Completed collaboratively, face-to-face with a trained provider¤ Introduce safety plan: suicidal crises come and go and safety plan helps prevent acting on

suicidal feelings and enhances self-efficacy and sense of self control (Stanley & Brown, 2012)

n Patients who received SPI as part of an ED visit for a suicide-related concern were half as likely to exhibit suicidal behavior and twice as likely to attend at least 1 outpatient mental health visit than the comparison group who did not receive SPI (Stanley et al., 2018)

BNI Source: https://www.bu.edu/bniart/sbirt-in-health-care/sbirt-brief-negotiated-interview-bni/

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Safety Planning Intervention: Steps 1-3

1. Warning Signs¤ “What do you experience when you start to think about suicide or feel extremely

depressed?”¤ “How will you know when the safety plan should be used?”¤ List warning signs using patient’s own words

2. Internal Coping Strategies¤ “What can you do, on your own, if you become suicidal again, to resist acting on your

thoughts or urges?”¤ “How likely is it that you would do this in a time of crisis?”¤ [If doubt is expressed] “What might prevent you from doing these activities?”

3. Social Contacts Who May Distract from the Crisis¤ “Who may help you take your mind off of problems at least for a little while?” “Who helps

you feel better when you talk with them?”

Source: Suicide Prevention Resource Center

http://www.sprc.org/sites/default/files/SafetyPlanningGuide%20Quick%20Guide%20for%20Clinicians.pdf

Safety Planning Intervention: Steps 4-6

4. Family Members or Friends Who May Offer Help¤ “Among your family or friends, who do you think you could contact for help during a

crisis?” “Who do you feel you can talk with when you’re under stress?”5. Professionals and Agencies to Contact for Help

¤ “Who are the mental health professionals that we should identify to be on your safety plan?” “Are there other health care providers?”

¤ List name, numbers and/or locations of clinicians and local urgent care services6. Making the Environment Safe

¤ “Do you own a firearm, such as a gun or rifle?” “What other means do you have access to and may use to attempt to kill yourself?”

¤ “How can we go about developing a plan to limit your access to these means?”

Source: Suicide Prevention Resource Center

http://www.sprc.org/sites/default/files/SafetyPlanningGuide%20Quick%20Guide%20for%20Clinicians.pdf

Follow-up and Monitoring: Structured Phone Follow-Up

¨ Assess mood and current risk¤ Administer C-SSRS (since last visit) to determine level of risk¤ If imminent risk detected, contact crisis line

¨ Review and revise safety plan¤ Remove unhelpful items and identify more helpful ones¤ Review access to means and whether there is a need to remove them

¨ Treatment engagement/motivation¤ Review treatment plan options and problem solve obstacles to treatment¤ Provide information on available community supports, Lifeline and Crisis Text Line

¨ Obtain consent/willingness for additional follow-up¤ Assess need for further calls and problem solve resistance¤ Set call time¤ Let client know how to initiate future care

Occurs 24-48 hours after initial contact to provide support during a time of elevated risk

Training module available from the Center for Practice Innovations http://zerosuicide.sprc.org/resources/structured-follow-and-monitoring-suicidal-individuals

Follow-up, Monitoring, and Referral

¨ Non-Demand Caring Contacts¤ Postcards, letters, emails or text messages containing brief expressions of

caring¤ Patients who refuse further care but receive these contacts had a lower

suicide rate than those in the comparison group who did not receive these contacts (Motto & Bostrom, 2001)

¨ Warm hand-off to other levels of care, suicide-specific treatment¤ Cognitive Behavioral Therapy for Suicide Prevention¤ Dialectical Behavioral Therapy¤ Collaborative Assessment and Management of Suicidality

Source: Zero Suicide Toolkit https://zerosuicide.sprc.org/toolkit/treat/interventions-suicide-risk#footnote3_6nqa0ya

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School-Specific Trainings

¨ Helping Students At Risk for Suicide (HSAR)¤ Trains on C-SSRS screening and assessment and Stanley-Brown Safety Plan

¨ Creating Suicide Safety in Schools¤ Workshop to assist schools in developing policies and procedures, including

screening using the C-SSRS and brief intervention using the Stanley-Brown Safety Plan

¨ Suicide Safety for Teachers¤ 1-hour awareness training to help teachers identify students at risk

Apps

MY3 Stanley-Brown Safety Plan

http://my3app.org/#stay-connected https://itunes.apple.com/us/app/safety-plan/id695122998#?platform=iphone

References

1 . Boston Un ive rsity Schoo l o f Pub lic Hea lth . The B rie f N egotia ted In te rv iew (BN I). Re trieved from http s://w w w .bu.edu/bnia rt/ sb irt- in-hea lth-ca re/sb irt-b rie f-nego tia ted -in te rv iew -bni/ .

2 . C ente rs fo r D isea se Contro l and P revention , N a tiona l Cente r fo r Hea lth S ta tistics . U nderly ing Cause o f Dea th 1999-2017 on CDC W O N DER O nline Da tabase , re lea sed Decem ber, 2018 . Da ta a re from the M ultip le Cause o f Dea th F ile s, 1999-2017 , a s com p iled from da ta p rov ided by the 57 v ita l sta tistics jurisd ictions through the V ita l S ta tistics Coopera tive P rog ram . Re trieved from http ://w onder.cd c.gov/ucd -icd10 .h tm l.

3 . C ente rs fo r D isea se Contro l and P revention . Su ic ide ris ing a cro ss the US . V ita l S igns. Re trieved from http s://w w w .cdc.gov/v ita ls igns/pdf/vs-0618-su ic ide-H .pd f.

4 . C ente rs fo r D isea se Contro l and P revention . W ISQ ARS non-fa ta l in jury da ta 2000-2016 . Re trieved from http s://w ebappa .cdc.gov/sa sw eb/ncip c/nfira te s.h tm l.

5 . C ente rs fo r D isea se Contro l and P revention . 2017 Youth R isk Behavio r Survey . Re trieved from http s://w w w .cdc.gov/hea lthyyouth/da ta/yrb s/re su lts .h tm .

6 . C o lum b ia L ighthouse P ro ject. Co lum b ia -Su ic ide Severity Ra ting Sca le . Re trieved from http ://cssrs .co lum b ia .edu/ .

7 . H edegaard , H ., C urtin , S .C ., & W arner, M . (2018 ). Su ic ide m orta lity in the United S ta te s, 1999-2017 . N CHS Da ta B rief , N o . 330 . Re trieved from http s://w w w .cdc.gov/nchs/da ta/da tabrie fs/db330-h .pd f.

8 . K roenke , K ., Sp itze r, R .L ., & W illiam s, J .B .W . (2001 ). The PHQ -9 : Va lid ity o f a b rie f dep ression severity m easure . Journa l o f G enera l In terna l M ed ic ine . 16 (9 ), 606-613 . DO I: 10 .1046/ j.1525-1497 .2001 .016009606 .x .

9 . M o tto , J .A . & Bostrom , A .G . (2001 ). A random ized contro lled tr ia l o f postcris is su ic ide p revention . Psych ia tric Serv ices . 52 (6 ), 828-833 .

1 0 . Rocke t, I.R .H ., Ca ine , E .D ., Connery , H .S ., & G reenfie ld , S .F . (2018 ). M orta lity in the Un ited S ta te s from se lf - in jury surpa sse s d iabe te s: A p revention im pera tive . In jury P revention . DO I: 10 .1136/ in juryp rev-2018-042889 .

1 1 . S cho ll, L ., Se th , P ., Ka riisa , M ., W ilson , N ., & Ba ldw in , G . (2018 ). D rug and op io id -invo lved overdose dea ths – United S ta te s, 2013-2017 . M orb id ity and M orta lity W eekly Report . Re trieved from http s://w w w .cdc.gov/m m w r/vo lum es/67/w r/m m 675152e1 .h tm ?s_cid= m m 675152e1_w .

1 2 . S tan ley , B . B row n, G .K , & B renner, L .A . (2018 ). Com parison o f the Sa fe ty P lann ing In te rvention w ith fo llow -up vs usua l ca re o f su ic ida l pa tients trea ted in the em ergency departm ent. JAM A Psych ia try . 75 (9 ), 894-900 .

DO I: 10 .1001/ jam apsych ia try .2018 .1776 .

1 3 . S tan ley , B . & B row n, G .K . (2012 ). Sa fe ty p lann ing in te rvention : A b rie f in te rvention to m itiga te su ic ide risk . Cognitive and Behav io ra l P ractice . 19 , 256-264 .

1 4 . Sub stance Abuse and M enta l Hea lth Serv ice s Adm in istra tion . (2017 ). Key sub stance use and m enta l hea lth ind ica to rs in the Un ited S ta te s: Re su lts from the 2016 N a tiona l Survey on D rug U se and Hea lth . Re trieved from http s://w w w .sam hsa .gov/da ta/site s/defau lt/ file s/N SDUH-FFR1 -2016/N SDUH-FFR1 -2016 .pd f.

1 5 . Sub stance Abuse and M enta l Hea lth Serv ice s Adm in istra tion . (2016 ). Sub stance use and Su ic ide : A nexus requ iring a pub lic hea lth approach . 2016 . Re trieved from http ://sto re .sam hsa .gov/sh in/content//SM A16-4935/SM A16-4935 .pd f.

1 6 . Su ic ide P revention Resource Cente r. (2008 ). Sa fe ty p lann ing gu ide . Re trieved from http ://w w w .sp rc .o rg/site s/defau lt/ file s/Sa fe tyP lann ingG uide% 20Q uick% 20G uide% 20for% 20C lin ic ians.pd f.

1 7 . Su ic ide P revention Resource Cente r. Ze ro Su ic ide too lk it. Re trieved from http s://zerosu ic ide .sp rc .o rg/ too lk it/ trea t/ in te rventions-su ic ide-risk# foo tno te3_6nqa0ya .

Thank You!

Brett Harris, DrPHClinical Assistant ProfessorUniversity at Albany School of Public Healthbharris@albany.edu

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In Our Last Few Moments…

https://sbirt.webs.com/suicide-sbirt

¨ PowerPoint Slides

¨ Certificate of Attendance

¨ On Demand Access 24/7

¨ Evaluation Survey

¨ Follow-up Email

Learner’s Guide to Adolescent SBIRT Curriculum

¨ Request a copy here: https://sbirt.webs.com/curriculum

SBI with Adolescents Simulation

¨ The education presented in this session complements the SBI with Adolescents online simulation training.

¨ Watch Trailer and Take Demo: https://kognito.com/products/sbi-with-adolescents

Learner’s Guide to Adolescent SBIRT

¨ Comprehensive introduction to SBIRT for adolescents and young adults.

¨ Examines each component of SBIRT and motivational interviewing skills.

¨ Each module includes:¤ Comprehensive Education and Training Content¤ Learning Objectives¤ Suggested Readings¤ Sample Conversations and Dialogue¤ Role Play Activities

¨ Used as part of education and training, and paced learning.

Module 1 What is SBIRT for Youth and Why Use it?

Module 2 Screening

Module 3 Brief Intervention

Module 4 Referral to Treatment and Follow-up

Module 5 Motivational Interviewing Strategieshttps://sbirt.webs.com/curriculum

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Online Resources and Materials

https://sbirt.webs.com/resources

Learn More About The Toolkit

§ SBIRT for Youth Learning Community: Adolescent SBIRT Toolkit (on-demand): http://my.ireta.org/node/1173

SBIRT Technical Assistance

Do you have questions about SBIRT implementation, evaluation, or training?

Schedule a free telephonic Technical Assistance session with Tracy McPherson, SBIRT Training, Technical Assistance, and Evaluation Lead.

Email Dr. McPherson at mcpherson-tracy@norc.org

Thank You for Attending!

www.sbirt.webs.com sbirtteam@norc.org