WBT Flipbooks

7 TFAH • WBT • PaininTheNation.org The Screening, Brief Inter vention, and Referral to Treatment (SBIRT) method is a public health approach recommended by the Substance Abuse and Mental Health Ser vices Administration (SAMHSA) for the early identification and treatment of substance misuse. 34 It is also the only prevention inter vention recommended in the President's Commission on Combating Drug Addiction and the Opioid Crisis. 35 SBIRT provides a systematic means of identifying and providing appropriate ser vices to people who clearly need, but are not receiving, treatment. Massachusetts passed a law in 2016 requiring public schools to verbally screen middle and high school students for substance use disorders using a validated screening tool. 36 The use of this tool enables school health teams to detect risk for substance-use- related problems and deploy brief inter vention strategies to address these concerns at an early stage. Additional validated assessment tools used for screening children include: l CRAFFT, a six-question behavioral health questionnaire for youth recommended by the American Academy of Pediatrics to help identify substance misuse; 37 l The Pediatric Symptom Checklist, a comprehensive assessment of a child's emotional and behavioral health; 38 and l Rapid Assessment for Adolescent Preventive Services, a five-minute screening system for risk behaviors that contribute to adolescent and young adult morbidity and mortality tailored to different age groups. 39 Personnel To adequately meet the behavioral needs of their students, schools may need to expand their staff and/or develop partnerships to provide more services, such as those provided by school counselors, mental health workers, school social workers, school nurses, school psychologists, and other healthcare staff. These professionals can: l Provide support and intervention to students; l Consult with families and teachers; l Promote positive peer relationships; l Provide social problem solving and conflict resolution; l Develop school-wide practices and approaches; and l Connect and collaborate with community providers for needed services. Schools can partner with behavioral health specialists in the local community to provide these services in addition to offering them directly onsite through school-based health professionals. Such partnerships foster sustainability and can enhance funding opportunities. Whether provided through the school or community partnerships, Medicaid reimbursement may be available to support these services for eligible students in many states under Medicaid's Early Periodic Screening, Diagnosis and Treatment benefit. An example of this type of successful school- community partnership is in Washington, D.C., where Mary's Center (a Federally Qualified Health Center) operates a mental health program in 16 public schools. The program helps to decrease access barriers and promote behavioral wellness for children and their families by providing diagnostic assessments and behavioral health services. 40 Billing for Medicaid services (like individual, group or family therapy) allows Mary's Center to broaden its support within the school to other typically non-billable school-wide mental health promotion and prevention services, such as lessons on social-emotional wellness, workshops for parents on positive discipline and stress management, and trainings for teachers on trauma-informed education. In the 2016- 2017 school year, 57 percent of school based mental health clients had an improvement of 10 points or greater during at least three months of treatment on the 30-point Child and Adolescent Functional Assessment Scale. 41

• Cover