Resumption of SBIRT Screening at Marshall Student Health, Observing Outcomes After COVID-19

Abstract

PURPOSE: Screening, Brief Intervention, and Referral to Treatment (SBIRT) is an evidence-based approach to identifying at-risk individuals, reducing problematic substance use, and preventing alcohol and substance use disorders. The project aimed to resume SBIRT screening and observe whether there might be changes among Marshall University students. The secondary aim was early intervention, decreasing substance misuse, and preventing the development of substance use disorder (SUD). METHODS: Data collection was conducted during the morning clinic of a student health service at a university in Appalachia from August 2023 through April 2024. SBIRT prescreens were completed by students during 606 visits. Student prescreening scores ranged from zero to a maximum of eight. All positive responses prompted a discussion with the student during the visit, and if appropriate, a referral to care or for treatment with medication was made. Anonymized data were managed in an Excel worksheet. SBIRT data from the 2023-24 academic year were compared to data from 428 students screened in 2017-2018, the last year of prior SBIRT screening. RESULTS: Of the 606 screenings: Score Frequencies 38.1% (n = 231) of students scored zero. 61.9% (n = 375) of students scored one to eight, indicating a positive SBIRT screen. 53.5% (n = 324) of students with a positive screen scored between one and three. Frequency of positive screens by screening question and the number of referrals made Three Drinks (n = 201) Another's Medicine (n = 6) More Medicine (n = 9) Marijuana Use (n = 86) Smoking or Vaping (n = 74) Depression (n = 205) Anxiety (n = 261) In Recovery (n = 5) Referrals for care (n = 94) In comparing the incidence rates between the two academic years: The rates of alcohol use, smoking, and medication misuse have decreased since 2017. Alcohol use “Three Drinks” decreased to 33.2% from 42.8%. Smoking or Vaping decreased to 12.2% from 21.7%. Prescription medication misuse decreased to 1.0% from 2.3%. The rates of anxiety and marijuana use increased in addition to the rate of referrals to care. The incidence of anxiety increased to 43.1% from 36.7%. Marijuana use increased to 14.2% from 12.4 %. Referrals for care increased to 15.0% from 13.6%. The rates of being in recovery, taking more medicine, and depression were similar. The incidence of “Being in Recovery” was 0.8% in 2023 and 0.7% in 2017. The incidence of “More Medicine” was 1.5% in 2023 and 1.6% in 2017 The rates of depression were 33.8% in 2023 and 33.7% in 2017. IMPLICATIONS FOR PRACTICE: The SBIRT screening instrument is a valid and effective tool for university student populations, providing a framework that facilitates discussing mental health and substance use. Students did not volunteer information without being prompted, underscoring the importance of screening and early intervention opportunities. SBIRT screening should be expanded. Screening will continue and needs to be expanded to include all student health encounters.