SBIRT PATHS - The Screening, Brief Intervention, and Referral to Treatment Prevention and Access to Treatment Hubs and Services (SBIRT PATHS) initiative will serve youth ages 12-21 with substance use and/or co-occurring disorders in five Connecticut counties (Fairfield, Hartford, New Haven, New London, Windham) to ensure more youth access effective care in a timely way. The SBIRT PATHS initiative will establish a Connecticut (CT) community-based model of co-occurring care for youth and will evolve its system of care by addressing gaps in early substance use services, the progression of substance use disorders alongside other unmet social needs, and connections between levels of care. The primary goal is to provide integrated substance use, mental health, and trauma-informed services for youth with low and moderate risk substance use. Four behavioral health providers will form regional SBIRT PATHS centers to serve youth and families in Fairfield, Hartford, New Haven, New London, and Windham counties. These providers include the Child and Family Agency, Child and Family Guidance Clinic, Clifford Beers Community Care Center, and Community Health Resources.
The SBIRT PATHS initiative will serve the five counties with the highest percentage of youth living below the poverty line and rank the highest for overall Social Vulnerability (socioeconomic status, household characteristics, racial and ethnic minority status, housing type, transportation). Black youth and youth with Hispanic ethnicity are served at higher rates in these counties due to behavioral health and other unmet social needs (e.g., housing, food security, transportation). In these rural and urban communities, more than one of every five youth report active substance use upon behavioral health service initiation each year.
This initiative will expand three evidence-based practices (EBPs) for youth utilizing a learning community framework: SBIRT, Motivational Enhancement Therapy/Cognitive Behavioral Therapy (MET/CBT), and Wraparound services. By grant end, at least 7,000 youth will be screened and 2,700 unduplicated youth who screen positive for substance use will be served by these EBPs (300 in year one, 600 annually in years two through five). This initiative will train more than 100 staff in SBIRT, 100 clinicians in MET/CBT, 20 care coordinators in Wraparound, and ensure EBPs are delivered with fidelity. A MET/CBT train-the-trainer model will be used to build capacity and sustainability. Adaptive continuous quality improvement consultation will ensure grant services achieve equitable outcomes for all youth subpopulations. At least 60% of youth who complete MET/CBT treatment will experience clinically meaningful symptom improvement, and more than 70% of youth will increase their periods of abstinence from service start to finish.
SBIRT PATHS centers will build community-based, localized partnerships to ensure youth are identified for screening and stay connected to services and care planning throughout treatment. Youth with co-occurring disorders and/or more acute substance use symptoms will receive warm handoffs to trauma-informed EBPs, specialized substance use disorder EBPs, and/or intermediate levels of care based on clinical need. This grant will have an Advisory Committee of key stakeholders, including SBIRT PATHS center leadership, CT Department of Children and Families, CT Department of Mental Health and Addiction Services, a MET/CBT national trainer, FAVOR (Connecticut's state organization for the National Federation of Families for Children’s Mental Health), and CCAR (Connecticut’s state organization for the National Alliance for Recovery Centered Organizations). FAVOR and CCAR will ensure participation from individuals with lived mental health and/or substance use experience, and/or family advocates of such individuals. The committee will help ensure initiative goals/objectives are met and more youth have access to evidence-based substance use services and treatment.
