Screening, Brief Intervention, and Treatment in a Latina Immigrant Prenatal Clinic

Abstract

Problem & Purpose: Babies born in Maryland found with drugs in their systems has increased 57.6 percent in the last 9 years. The American College of Obstetricians and Gynecologists recommends universal screening for substance use disorders at first prenatal visit. Substance use disorders are usually interrelated with other behavioral health issues requiring more comprehensive screening at primary care sites for better screening and treatment success. The use of a Screening, Brief Intervention, and Referral to Treatment (SBIRT) protocol combined with motivational interviewing (MI) has shown success in earlier identification and more successful referrals of behavioral health issues. The aim of this MAP-IT guided (Mobilize, Assess, Plan, Implement, Track) quality improvement project is to educate, better detect, and successfully refer out a Latinx immigrant prenatal patient population with suspected behavioral health issues to specialty behavioral health treatment centers to decrease negative long term behavioral health issues occurring in the community. Methods: Implement an SBIRT protocol for behavioral health. Train and use MI techniques when interacting with patients; support patients throughout the specialty referral process by being present and using same-day appointments; increase education about of behavioral health issues and their treatment; and track behavioral health issues from the clinic to the specialty referral site. Results: During the 12-week implementation period, four patients were identified with behavioral health issues with one patient being successfully referred to county behavioral health. Conclusions: The Latinx immigrant culture stigmatizes behavioral health. Increasing education and trust for behavioral health treatment must be a focus. Prenatal clinic employees should be trained in MI techniques and cultural engagement to successfully engage in patient collaboration for behavioral health issues. Repeated behavioral interventions are needed to increase the motivation needed to accept treatment. Behavioral health experts embedded in prenatal clinics would help make referrals and treatment more successful.