Resilience and Well-Being at Personal, Relational, and Collective Levels: Insights from Diverse Studies of Children and Adults

Results of the Georgia BASICS SBIRT Initiative

J. Aaron Johnson, PhDGabriel P. Kuperminc, Ph.D

Study Committee November 10, 2015

Georgia BASICSSBIRT Demonstration ProjectImplement universal screening in Emergency DepartmentsProvide Brief Intervention using Motivational Interviewing techniqueAdditional in-house therapy, referral to treatmentSettingsGrady Health System (Atlanta)Medical Center of Central Georgia (Macon)

Urban Emergency PatientsRiskPoverty, housing instabilityLack consistent health care, unmet needsBehaviors (e.g., alcohol, drug use) linked with health concernsED visit as Teachable MomentOpportunity to help patients make the connectionChange from blame for poor choices to increased motivation for positive choices

Brief Prescreen: 25% Pos.Patient Enters ED7% High RiskBI + BT54% Low- Moderate RiskBIPositive Prescreens receive ASSIST Full Screen7% Very High RiskBI+ RTBI = Brief InterventionBT = Brief TherapyRT = Referral to Treatment10% Sample enrolled For 6 month Follow UpNurseHealth Educators32% Screening FeedbackThis diagram helps explain the patient flow in the 2 ga emergency departments, and also shows you the breakdown in the delivery of services.4Georgia BASICS: Services ProvidedServices ProvidedScreening/Feedback154,429Brief Intervention (BI)21,193BI + Brief Therapy (BT)2,790BI + Referral to Tx (RT)3,176Total181,588EvaluationScreening:Identify Pts. Eligible for ServicesBrief InterventionBrief TherapyReferral to Treatment6-Month Follow UpINTERVENTION GROUPxxxCOMPARISON GROUPx0xStudy SampleComparison Group(N = 1737) SBIRT Group( N =1170)Years of Education11.7711.80Average Age4242Female34%29%African-American74%74%Employed Full or Part Time33%33%Unstably housed/Homeless49%48%Average Monthly Wage$807$571Notes: SBIRT pts enrolled in study via random selection from those receiving services.Control pts received screening/assessment but no services.6-month follow-ups completed w/ 50% of Control and 65% of SBIRT pts.

Intervention group decreased Substance Use Baseline to 6-mo Follow-upGreater Decreases in Binge Drinking for SBIRT vs. Control PatientsMental Health Improvements in Quality of LifeConclusionsREDUCED Alcohol and other Drug useSimilar to findings in other SBIRT studiesTend to be Larger for SBIRT vs. ComparisonBetter Evidence for Effectiveness with Alcohol than other DrugsMORE THAN SUBSTANCE USEImproved Mental Health may mark greater sense of control, help individuals choose to reduce use of substances

Thanks toSAMHSA, #TI019545 GA Div. Behavioral Health & Developmental DisabilitiesGSU Colleagues and StudentsGrady Health System & Medical Center of Central Georgia

For more information, contact:J. Aaron JohnsonAaron.Johnson@gru.edu

Gabriel Kupermincgkuperminc@gsu.edu