Adding telehealth consultation to school-based substance use screening programs helped providers build skills and improve early intervention for adolescents.

Background

Substance use disorders are common among youth despite screening and intervention models like SBIRT that aim to improve access to care. Barriers to SBIRT for youth include insufficient provider time and provider discomfort, knowledge gaps, and lack of training. This study describes the implementation and pilot evaluation of a school-based SBIRT enhanced with telehealth-delivered addiction consultation and education in a Project ECHO-style model, to improve provider confidence, knowledge, and practices in a school-based mental health program serving middle and high school students.

Findings

This pilot mixed-methods study included surveys (n=13 at baseline; n=7 post-implementation), one focus group (n=11), and ongoing qualitative feedback. Surveys completed by participating program providers were reviewed to identify themes on implementation successes and challenges. At baseline, 93% of providers reported that addressing adolescent substance use was important, yet only 31% reported regularly delivering substance use interventions (compared to 77% for mood-related care). Early implementation outcomes showed providers reported greater confidence, knowledge, evidence-based screening, and early intervention practices in delivering these services virtually to youth in a school setting. Ongoing barriers were related to referral to substance use disorder treatment and delivering appropriate services to younger students.

Program/Policy Takeaways

Telehealth case consultation can help providers build confidence and improve screening and early intervention for adolescent substance use in schools. Providers can consider integrating structured screening and ongoing consultation into practice, as well as proactively establish referral pathways, to ensure students can access needed treatment.