Healthcare-Based Prevention Resources
Screening, Brief Intervention, and Referral to Treatment (SBIRT)
- SBIRT Implementation Resources
- Screening Resources
- Brief Intervention Resources
- Referral to Treatment Resources
SBIRT is a comprehensive, integrated public health approach to the delivery of early intervention and treatment for individuals with substance use disorder, depression, and suicidality, as well as those at risk of developing these issues. SBIRT services utilize universal screenings to identify problematic mental health and substance abuse issues, employs brief interventions to address unhealthy behaviors, and offers referrals to treatment when a great level of care is required. Primary care centers, family medicine clinics, hospitals, emergency departments, and trauma centers can provide a great opportunity for early intervention before more sever consequences occur.
- Screenings take only a few minutes!
- Multiple studies show reduction in harmful behaviors due to SBIRT interventions.
- SBIRT can be tailored with different screenings and assessments.
- SBIRT services can be reimbursed and lead to long-term healthcare cost savings.
- SBIRT services are endorsed by the World Health Organization, the U.S. Preventative Services Task Force, and the American College of Surgeons.
SBIRT can be used in a variety of settings, including primary care sites, hospitals, emergency departments, assisted living, home health, law enforcement, military, and schools. Although SBIRT implementation may lookd ifferent in each of these locations, the goal is still the same: identify and reduce potential risky substance use and/or symptoms of depression and suicidality. You can learn more by reading the SBIRT documentation around Primary Care Sites, Emergency Departments, Hospitals, and Non-Medical Settings.
SBIRT Implementation Guides
- SAMHSA SBIRT
- National SBIRT Training of Trainers Manual - ATTC
- CDC Planning and Implementing SBI for Risky Alcohol Use: Guide for Primary Care
- Helping Patients Manage Substance Use Disorder: Tobacco, Alcohol, and other Drugs
- SAMHSA TAP 33: Systems-Level Implementation of SBIRT
- Adolescent SBIRT Toolkit for Providers
- Improving Adolescent Health: Facilitating Change for Excellence in SBIRT
- Companion Guide for Improving Adolescent Health
SBIRT Marketing Materials and Promotional Signage
For SBIRT marketing materials and promotional signage, contact the ODMHSAS Healthcare-Based Prevention Services Team.
Screening: Universal, evidence-based screening is used to identify unhealthy alcohol, drug or tobacco use and depression and suicide risk.
SBIRT Reimbursement Guides
- Reimbursement for SBIRT
- OHCA Patient-Centered Medical Home Behavioral Health Screening Toolkit
- Medicare Learning Network – Center for Medicare & Medicaid Services – SBIRT Services
- Coding for Screening and Brief Intervention Reimbursement (SAMHSA)
- American Medical Association Evaluation and Management (E/M) Office Visits
Brief Intervention: Provides feedback about risky behaviors and motivation toward healthy behavior change. It focuses on education and increasing patient insight and awareness about risks related to unhealthy substance use, depression, and suicide risk.
Kognito SBIRT Modules
Kognito creates digital experiences that prepare health-care providers for the conversations that matter most. Scientists, artists, and technologists use the latest principles behind neuroscience, social cognition, and game mechanics to create simulated conversations with virtual patients where you can learn, practice and self-assess your ability to manage conversations that can lead to positive changes in social, emotional, and physical health. The company's science-driven and research-proven approach have made Kognito the only company with health simulations listed in the National Registry of Evidence-Based Programs and Practices (NREPP).
Additional Brief Intervention Video Demonstartions
ODMHSAS Training Institute
Introduction to Motivational Interviewing: This is a two-day training. Motivational Interviewing (MI) is a collaborative, goal-oriented method of Communication with particular attention to the language of change. It intends to strengthen personal motivation for commitment to a target behavior change by eliciting and exploring an individual’s argument to make changes.
Patient-Facing Resources for Brief Intervention Support
Referral to Treatment: Provides those identified as needing more extensive treatment with access to specialty care for mental health services and addiction assessment and treatment.
- Oklahoma Network of Care Treatment Services Locator (Statewide)
- SAMHSA Behavioral Health Treatment Services Locator (Nationwide)
- Psychology Today Directory – Therapists, Psychiatrists, Support Groups
Additional Referral to Treatment Resources
Do No Harm: Pain and Opioid Management
- Current Issues in Practice
- Training and Academic Detailing
- Practice Tools and Documents
- Patient Education and Provider Resources
- Overdose Education and Naloxone Distribution
Do No Harm: Pain and Opioid Management provides best practices and technical assistance for the safe and responsible treatment of chronic pain, including opioid prescriptions, when indicated. The goals of the Do No Harm program are to improve patient-centered care and safety, leading to improvements in pain management and daily functioning. Through the delivery of evidence-based guidelines and safe opioid prescribing recommendations, Do No Harm seeks to provide quality improvements to the delivery of primary and mental health care services. In collaboration with the Do No Harm program, the ODMHSAS Overdose Education and Naloxone Distribution (OEND) program assists in combating the opioid epidemic and reducing fatal overdoses by improving access to naloxone and providing additional resources for the treatment of substance use disorders.
Need for Programming
Opioid Prescribing Guidelines
- Federal Guidelines for Opioid Treatment Programs
- CDC Guideline for Prescribing Opioids for Chronic Pain
- Oklahoma Emergency Department (ED) and Urgent Care Clinic (UCC) Opioid Prescribing Guidelines
- Opioid Prescribing Guidelines for Oklahoma Health Care Providers in the Office-Based Setting
Prescription Monitoring Program
- Prescription Monitoring Progam (Oklahoma PMP AWARE Login)
- Oklahoma Bureau of Narcotics and Dangerous Drugs
- Oklahoma Bureau of Narcotics and Dangerous Drug Control PMP and Prescribing Practices Training
- Oklahoma Bureau of Narcotics and Dangerous Drug Control Programs and Services
- OHCA Provider Letter - Opioid Quantity Limit
- Quantity Limits Analgesics - Opioids
- Quantity Limits Analgesics, NSAIDs, and Antipyretics
Letters of Support and Endorsements
- Managing Side Effects and Complications of Opioid Therapy for Chronic Pain Fact Sheet
- Prescription Medications: Misuse, Abuse Dependence, and Addiction Fact Sheet
- RX Pain Medication. Know the Options, Get the Facts Fact Sheet
- OHCA Prior Authorization Criteria
- SoonerCare Brand Name Required Drug List
- Adapting Prevention Interventions to Better Serve People Who are Under-Resourced
- Oklahoma Duty to Report
- Pregnancy and Opioid Pain Medications Fact Sheet
- Neonatal Abstinence Syndrome: Information for the Primary Care Provider and Guidelines for Referral
- OHCA Opioids in Pregnancy PowerPoint Presentation
Children and Adolescents
- Talking with Teens about Alcohol and Other Drugs Fact Sheet
- Behavioral Health Among College Students Fact Sheet
- Prescription Drugs: They Can Help but Also Hurt: Not Worth the Risk Fact Sheet
- Risk Factors for Youth Substance Misuse (PTTC Network)
- Talk. They Hear. Student Assistance Resources
- Tips for Teens: Opioids (SAMHSA)
Mental Health Comorbidity
- Opioid Use Disorder DSM-5 Diagnostic Criteria
- Overdose Grief, Loss, and Healing Supports (PTTC Network)
Naloxone Co-Prescribing Guidelines
Do No Harm Dental: Putting Safer Pain Management into Practice
The University of Oklahoma College of Dentistry, in association with the Oklahoma Department of Mental Health, is pleased to announce a new continuing education program titled “DO NO HARM: Putting Safer Pain Management into Practice.” This program was created specifically to satisfy the educational requirements for Oklahoma dental licensure. The two-hour CE was derived from the University of Oklahoma Health Sciences Center Oklahoma Primary Healthcare Improvement Cooperative’s program created to provide CME credits to clinicians.
Patient Education Resources
- RX Pain Medications (SAMHSA)
- How to Dispose of Medicines Properly (EPA)
- No More Than Four (OHCA)
- MME Infographic (OHCA)
- 988 Mental Health Lifeline
- Oklahoma 2-1-1 Resource Directory
- Never Use Alone 24/7 Overdose Response Hotline
- Take Back Day
- OHCA Substance Use Stewardship
- Agency for Healthcare Research and Quality (AHRQ)
- Addiction Technology Transfer Center Network (ATTC)
- Prevention Technology Transfer Center Network (PTTC)
Additional Referral Network Resources:
Overdose Education and Naloxone Distribution (OEND)
The ODMHSAS partners with healthcare facilities serving populations identified as high risk for opioid overdose to implement Overdose Education and Naloxone Distribution (OEND) programs. OEND programs aim to reduce harm and risk of life-threatening opioid-related overdose deaths among Oklahomans. Key components of the ODMHSAS Healthcare-based OEND program include access to free overdose reversal kits (naloxone) for distribution to persons identified as at risk of witnessing or experiencing opioid overdose training in opioid overdose prevention, opioid overdose rescue response with naloxone, and additional harm reduction strategies, including fentanyl test strips (FTS), medication lockboxes, medication disposal bags, and gun locks. For more information or to see if your facility qualifies for the Healthcare-Based OEND program, contact the ODMHSAS Healthcare-Based Prevention Services Team.
OK I'm Ready
Free naloxone kits are available to anyone in the state of Oklahoma through ODMHSAS' mail-out program. To request a free kit be mailed to a residence, or to learn more about the prevention and treatment of Substance Use Disorder (SUD), visit the OK I'm Ready website. For OK I'm Ready resources and materials to provide to patients, contact the ODMHSAS Healthcare-Based Prevention Services Team.
Zero Suicide in Healthcare
- Resources for Healthcare Staff
Zero Suicide in Healthcare is a way to improve suicide care within healthcare systems. The foundational belief of Zero Suicide is that suicide deaths for individuals under the care of medical providers are preventable; studies have shown the majority of people who died by suicide saw a healthcare provider in the year prior to their death. For healthcare systems dedicated to improving patient safety and stability, Zero Suicide offers an aspirational challenge and practical framework for system-wide transformation toward safer suicide care. Zero Suicide is based on the realization that people experiencing suicidal thoughts and urges often fall through the cracks in a sometimes fragmented health care system. There is an opportunity for health care systems to make a real difference by transforming the care patients receive.
Current Suicide Trends
- Suicide is the 9th leading cause of death in Oklahoma.2
- In 2020, 869 Oklahomans died by suicide.2
- The age adjusted suicide rate in 2020 was 22.2 per 100,000 individuals, higher than the national rate.2
- On average, one person died by suicide every 11 hours in Oklahoma.2
- In 2020, firearms accounted for 61.9% of all suicide deaths.2
In the United States:
- Suicide is the 12th leading cause of death.1
- In 2020, 45,979 Americans died by suicide; an estimated 1.2M suicide attempts were made.1
- The age-adjusted suicide rate in 2020 was 13.48 per 100,000 individuals.1
- On average, there are 130 suicides per day.1
- In 2020, firearms accounted for 52.83% of all suicide deaths.1
Zero Suicide Research
- The Relationship Between Suicidal Behaviors and Zero Suicide Organizational Best Practices in Outpatient Mental Health Clinics
- Efficacy of the Zero Suicide framework in reducing recurrent suicide attempts: cross-sectional and time-to-recurrent-event analyses
Zero Suicide Outcome Stories
- Zero Suicide Outcomes One-Pager
- Zero Suicide Case Studies
Zero Suicide Foundational Principles
- Core Values: the belief and commitment that suicide can be eliminated in a population under care by improving service access and quality and through practicing continuous quality improvement.
- Systems Management: taking systematic steps across systems of care to create a culture that no longer finds suicide acceptable, setting aggressive but achievable goals to eliminate suicide attempts and deaths, and organizing service delivery and support accordingly.
- Evidence-Based Clinical Care Practices: adopting practices that research shows reduce suicide deaths and behaviors and that are delivered through the entire system of care and that emphasize productive patient-staff interactions.
Lead system-wide culture change committed to reducing suicides
2021 Zero Suicide Summit: Zero Suicide in Primary Care
Suicide Prevention Resource Center (SPRC)
Identify individuals with suicide risk via comprehensive screening and assessment
- PHQ-9: Patient Health Questionnaire
- C-SSRS: Columbia Suicide Severity Ratings Scale
- ASQ: Ask Suicide-Screening Questions
- PSS-3: Patient Safety Screener
- SAFE-T: Suicide Assessment Five-Step Evaluation and Triage
Additional Screening Resources
Engage all individuals at-risk of suicide using a suicide management plan
Pathways to Care
- ZS Pathway to Care
- Institute for Family Health Clinical Pathways for Managing Suicidality
- ZS Suicide Care Pathway Coding for Primary and Behavioral Health Care
- Care Pathways: Centerstone – Adding a Pathway to our Treatment Plan Fact Sheet
- Caring for Adult Patients with Suicide Risk: A Consensus Guide for Emergency Departments
- Integrated Primary Care & Behavioral Health
- Substance Use Disorder Treatment
- Inpatient Mental Health
- Stanley Brown Safety Plan
- Safety Planning Intervention: A Brief Intervention to Mitigate Suicide Risk
- Development of a Clinical Guide to Enhance Care for Suicidal Patients
- Ethical and Competent Care of Suicidal Patients: Contemporary Challenges, New Developments, and Considerations for Clinical Practice
- Building a Therapeutic Alliance with the Suicidal Patient
Native Americans & Alaska Native
- ZS Keys for Sustainability for Health and Behavioral Health Care Programs in Indian Country
- Is Your Tribal or IHS-Led System Ready to Implement Zero Suicide?
- Is Your Tribal or HIS-Led System Not Quite Ready to Implement Zero Suicide?
- Getting Started with Zero Suicide for Tribal and HIS-Led Systems
Military & Veterans
- VA/DoD Clinical Practice Guideline for the Assessment and Management of Patients At Risk for Suicide
- Treatment Works for Vets
- Suicide Risk Management Consultation Program
Children & Youth
- Adolescent Suicide Prevention and Medical Settings (Webinar)
- OKCAPMAP – Oklahoma Child and Adoloescent Psychiatry and Mental Health Access Program
Treat suicidal thoughts and behaviors directly using evidence-based treatments
CALM: Counseling on Access to Lethal Means
Reducing access to lethal means, such as firearms and medication, can determine whether a person at risk for suicide lives or dies. This free online course focuses on how to reduce access to the methods people use to kill themselves. It covers how to: (1) identify people who could benefit from lethal means counseling, (2) ask about their access to lethal methods, and (3) work with them—and their families—to reduce access. While this course is primarily designed for mental health professionals, others who work with people at risk for suicide, like social service professionals and health care providers, may also benefit from taking it.
Patient Facing Resources
- NIMH My Mental Health: Do I Need Help?
- NIMH Tips for Talking with a Healthcare Provider about your Mental Health
- NIMH Stress Catcher: Catch Some Great Coping Strategies and Skills for Managing Stress
- NIMH Warning Signs of Suicide
- NIMH I’m So Stressed Out Fact Sheet
- NIMH Five Action Steps for Helping Someone in Emotional Pain
Transition individuals through care with warm hand-offs and supportive contacts
- Best Practices in Care Transitions for Individuals with Suicide Risk: Inpatient Care to Outpatient Care
Referral Network for Patients
- 988 Suicide & Crisis Line
- Oklahoma Network of Care Treatment Services Locator (Statewide)
- SAMHSA Behavioral Health Treatment Services Locator (Nationwide)
Improve policies and procedures through continuous quality improvement
- RAND Suicide Prevention Program Evaluation Toolkit
- Zero Suicide Data Elements Worksheet
- Framework for Conducting a Root Cause Analysis and Action Plan
- Zero Suicide Breakthrough Series: Outcomes and Recommendations
Additional Suicide Prevention Resources
- American Hospital Association (AHA)
- American Psychiatric Association Practice Guidelines for the Assessment and Treatment of Patients with Suicidal Behaviors
- American Foundation for Suicide Prevention (AFSP)
- Substance Abuse and Mental Health Services Administration (SAMHSA)
- Suicide Awareness Voices of Education (SAVE)
- Suicide Prevention Resource Center (SPRC)
- World Health Organization (WHO)
Healthcare Staff Self-Care Resources
- Oklahoma State Medical Association Physician Wellness Program
- A Guide to Promoting Healthcare Workforce Well-Being: During and After COVID-19 Pandemic
- Bolstering Resilience for Frontline Staff
- Telehealth Tips: Managing Suicidal Clients During the COVID-19 Pandemic
- Caring for Your Mental Health (NIMH)
- RPR Exchange: University of Oklahoma Health Sciences Center