SBIRT for Substance Abuse in Mental Health Treatment Settings

描述（由申请人提供）：精神卫生治疗机构药物滥用的SBIRT项目描述估计有40%的精神卫生治疗机构的患者从事有害的酒精和/或药物使用。然而，精神卫生诊所往往不提供干预或转诊到这些患者的特殊物质使用障碍（SUD）治疗。在医疗环境中，一种被证明有效的干预模式是筛查、短暂干预和转诊治疗（SBIRT），以减少酒精使用和/或促进成瘾治疗的参与。尽管在医疗环境中，SBIRT对高风险酒精使用有效，但关于SBIRT对药物使用有效性的研究有限，没有关于精神健康治疗环境中SBIRT有效性的研究。鉴于同样使用有害物质的精神健康患者的比例很大，而且精神健康诊所对物质使用问题的关注有限，需要进行研究，为这些环境中的患者找到适当和有效的物质使用干预措施。拟议的研究使用一项随机对照试验来检查世界卫生组织的SBIRT模型，ASSIST（酒精、吸烟和物质介入筛查测试）及其相关的简短行为干预，在多大程度上导致减少精神卫生机构中普遍存在的物质：酒精、大麻和兴奋剂（即可卡因和甲基苯丙胺）。该研究还将检查SBIRT对改善精神症状、改善生活质量的影响，以及对那些药物滥用程度表明需要治疗、开始和参与SUD治疗服务的人的影响。合格的参与者将是报告过去一年使用大麻或兴奋剂或过去一年至少有一天大量饮酒的精神健康患者。该研究的一个探索性目的是确定最高风险是酒精、大麻或兴奋剂的患者的SBIRT的效应大小。符合资格标准的精神健康患者（n = 1,080）将被纳入研究，并随机分配到SBIRT干预组或健康教育注意控制组。参与者将在药物使用、精神症状和生活质量方面进行基线评估。每个参与者将在3个月、6个月和12个月的随访点接受酒精和药物使用、参与SUD治疗服务、精神症状严重程度和生活质量的评估。随机效应增长模型将用于检验研究假设。如果成功，这项研究将产生关于精神健康治疗环境中精神健康疗法有效性的宝贵新知识，并将促进精神健康患者的健康改善。此外，该研究将提供证据，证明SBIRT在减少非法药物使用方面的有效性。这项研究的结果将作为在精神卫生机构更广泛地传播和推广SBIRT的基础。

DESCRIPTION (provided by applicant): SBIRT for Substance Abuse in Mental Health Treatment Settings Project Description An estimated 40% of patients in mental health treatment settings engage in hazardous alcohol and/or drug use. Yet mental health clinics often do not provide intervention or referral to specialty substance use disorder (SUD) treatment for these patients. One model of intervention that has been shown effective in medical settings to reduce alcohol use and/or promote engagement in addiction treatment is screening, brief intervention, and referral to treatment (SBIRT). Despite the effectiveness of SBIRT for risky alcohol use in medical settings, there has been limited research on the effectiveness of SBIRT for drug use and no research on the effectiveness of SBIRT in mental health treatment settings. Given the proportionately large number of mental health patients who also engage in hazardous substance use and the limited attention given to substance use issues in mental health clinics, research is needed to find an appropriate and effective substance use intervention for patients in these settings. The proposed study uses a randomized controlled trial to examine the extent to which the World Health Organization's SBIRT model, the ASSIST (Alcohol, Smoking, and Substance Involvement Screening Test) and its associated brief behavioral intervention, leads to reductions in substances prevalent in mental health settings: alcohol, cannabis and stimulants (i.e., cocaine and methamphetamine). The study will also examine the effect of SBIRT on improvement in psychiatric symptoms, improved quality of life and for those whose level of substance misuse indicates a need for treatment, initiation and engagement into SUD treatment services. Eligible participants will be mental health patients who report any past year use of cannabis or stimulants or at least one heavy drinking day in the past year. An exploratory aim of the study is to identify effect sizes of SBIRT for patients whose highest risk is for alcoho, cannabis or stimulants. Mental health patients (n = 1,080) who meet eligibility criteria will be enrolled and randomly assigned to either the SBIRT intervention condition or to a health education attention control condition. Participants will be assessed at baseline on substance use, psychiatric symptoms and quality of life. Each participant will be assessed at 3-, 6- and 12- month follow up points for alcohol and drug use, involvement in SUD treatment services, severity of psychiatric symptoms and quality of life. Random effects growth models will be used to test the study hypotheses. If successful this study will yield valuable new knowledge about the effectiveness of SBIRT in mental health treatment settings and will promote improved well being of mental health patients. Further, the study will provide evidence on the effectiveness of SBIRT for reducing illicit drug use. Results from this research will be used as the basis for broader dissemination and of SBIRT in mental health settings.