Primary Care Screening, Brief Intervention, and Referral to Treatment (SBIRT) for Service Members' Spouses Experiencing Substance Use Disorders

The stressors of deployment and combat place service members at increased risk for developing mental health problems such as depression, posttraumatic stress disorder (PTSD), and alcohol misuse. Additionally, family members are also at risk; child maltreatment and spousal abuse rates are correlated with substance misuse and chronic mental health problems. Despite little research focusing on spouses of service members, stigma and distrust in specialty mental health care have been implicated as major barriers for spouses receiving care before, during, and after deployment. Left untreated, these problems lead to long term health consequences such as injuries, neurological problems, and even death. The Center for Substance Abuse Treatment (CSAT) guidelines urge primary care providers (PCPs) to integrate and coordinate screening and treatment approaches into their practice. PCPs who use screening tools and brief interventions to identify and treat patients provide immediate attention to patients struggling with mental health and substance use issues. Additionally, brief interventions implemented with patients on waiting lists for specialized programs may be an effective initial treatment well as an adjunct to more extensive treatment for substance-dependent persons and those with more seriouse mental health disorders. SBIRT is easily implemented in PCP offices and may be a valuable model for addressing behavioral health needs of post-deployed veterans. The presentation describes findings from a series of focus groups held with veterans' spouses and PCPs to identify barriers to behavioral health treatment and perceived PCP training needs to better serve this population.