More than 12,000 brief screens for alcohol, drugs, tobacco and depression have been completed by WIPHL’s first three Partners in Integrated Care project clinics since November 2011. Bellin Health – Howard, Bellin Health – Ashwaubenon and Northern Health Center clinics screened patients for unhealthy drinking and drug use, tobacco use and depression, providing intervention and referral to treatment, if needed.
Administered by a trained health educator, BSI is proven to reduce alcohol and drug use – the fourth leading cause of death in Wisconsin – and healthcare costs. Behavioral screening and intervention (BSI) is top-tier recommended service and endorsed by the CDC, Joint Commission, National Business Group on Health, NIH, US Preventive Services Task Force and Wisconsin Medical Society.
A health educator who delivers SBIRT services in a Wisconsin healthcare clinic tells the story of how a brief intervention a patient getting much-needed mental health and financial help. (Some details have been changed to protect patient confidentiality.)
The health educator met with a male patient who scored high on the risk assessment and indicated he was a daily drinker, typically consuming 5 to 8 drinks per day and 10 or more during the weekends. He had experienced several significant consequences from his alcohol use – including a DUI and a fall that led to a significant injury.
Despite the negative impacts he was experiencing from his drinking, he initially had no intention of making any changes when he first met with the health educator. The health educator engaged with him in an exploration of his motivation for drinking, and he agreed to a follow-up phone call. When the health educator reached him by phone several weeks late,r he surprised her by sharing that he had not had a drop to drink in 18 days!
May is Mental Health Awareness Month and an important time to continue the conversation about mental health treatment. Anxiety, depression, bipolar disorder, schizophrenia and other disorders too often go undiagnosed or misdiagnosed, keeping patients from living a full, productive life. This year alone, one in five Wisconsinites will be affected by a mental illness.
At WIPHL, we know first-hand how detrimental mental health disorders can be in patients’ lives. That’s why we work with primary care settings to implement behavioral screening and intervention (BSI), which helps address depression and other mental health disorders by screening all patients annually, making frequent contacts with patients and providing interventions to maximize engagement in and promotion of behaviors that lift symptoms. BSI would help uncover almost all cases of depression, double response to treatment and increase complete remission by 77%.
By Mia Croyle, MA
In the third edition of Motivational Interviewing: Helping People Change (Miller & Rollnick, 2013), we are introduced to the four processes. The first of these is engaging. Our goal in this process is to establish and maintain a collaborative working relationship with the other person.
Ways to promote engagement:
- Ask for and listen to what the other person wants
- Seek an understanding of how important the topic at hand may be to the other person
- Look for what you can genuinely appreciate and comment positively about
- Provide the person with some sense of what to expect
- Offer hope – explain how what you do may help
Ways to promote disengagement:
- Assume an expert role
- Move too quickly into an assessment process
- Prematurely focus on one specific problem
- Use language that indicates labeling or blaming