**Tennessee Screening, Brief Intervention and Referral to Treatment**

SBIRT-TN is administered by the Department of Mental Health and Substance Abuse Services (TDMHSAS) Division of Substance Abuse Services and is designed to expand and enhance Tennessee’s continuum of care for substance misuse and to reduce alcohol and drug consumption and its negative impact; increase abstinence and reduce costly health care utilization; promote sustainability and behavioral health information technology.

At-risk individuals are those who consume alcohol or other substances in ways that could lead to dependency and interfere with healthy lifestyles.  Often, patients are not conscious of substance use behaviors leading to disruptive and unhealthy conditions such as addictions, physiological and mental disorders, and negatively impacted family and communal relationships.  The SBIRT approach provides for early intervention and treatment for at-risk individuals before severe consequences occur.

**Special Features and Population**

Tennessee is the 17th most populated state with 6,495,987 residents and ranks 11th in the nation for population growth (US Census 2010). Within this population there are three distinct but strikingly similar subgroups served by the SBIRT TN project who share common risk factors and they represent the geographic and cultural diversity of Tennessee.  SBIRT TN implementation has targeted these high-risk populations at the following sites:   

1. Medical Clinic, Bristol, TN (ETSU) implemented serves in project Year 1 for the predominately poor white Appalachian communities of rural Northeast Tennessee;

2. Medical Clinic, Johnson City, TN (ETSU) implemented serves in project Year 2 for the predominately poor white Appalachian populations of rural Northeast Tennessee;

3. Medical Clinic, Kingsport, TN (ETSU) implemented serves in project Year 3 for the predominately poor white Appalachian populations of rural Northeast Tennessee;

4. Meharry Medical Clinic, Nashville, TN implemented serves in project Year 1 for the urban poor African American populations in North Nashville;

5. Madison Medical Clinic, Nashville, TN (UNHS) was added to the project in Year 2, and serve the urban poor African American and Hispanic populations in Northeast Nashville;

6. Tennessee Nation Guard (TNNG) Armory, Milan, TN implemented services in project Year 4 during Periodic Health Assessments; and

7. Tennessee National Guard (TNNG) Volunteer Training Center, Smyrna, TN implemented services in project Year 2 during Periodic Health Assessments. 

The project has served more than 21,000 patents, developed a sustainable SBIRT training capacity and is piloting SBIRT in a Public Health Clinic in partnership with the TN Department of Health (DOH). Once the pilot is completed the DOH intends to expand the process statewide. This has the potential to reach millions of patients. 

**SBIRT TN Enhancements (Proposed for Year 4)**

The “Champions Program” is designed to engage doctor’s to act as SBIRT ambassadors and advocates within their professional sphere of influence. Qualified “Champions” will gain expertise in the SBIRT process by implementing SBIRT within their practice and through trainings and literature research.  Once prepared, Champions will provide presentations at professional meetings and gatherings as well as state medical conferences and through publications.  The “External Quality Improvement (QI) Strategy” will establish an unbiased external program to increase practitioner fidelity to the delivery model and assist project sites to develop/enhance a sustainable internal QI process. The strategy includes recording SBIRT sessions, scoring each session for model fidelity, individual critiques per session, and technical assistance by a recognized expert in the field. Measurable changes to fidelity adherence and improvements to local QI process are anticipated results of the program.  

For more information on SBIRT Tennessee, contact Angela McKinney Jones, Project Director (angela.mckinneyjones@tn.gov) or Dennis Berry, Project Coordinator (dennis.berry@tn.gov).