Health practitioners, support services and the community as a whole have hugely benefitted from the flow on effects of the Te Ara Oranga Screening, Brief Intervention and Referral to Treatment (SBIRT) programme at Whangarei Hospital's Emergency Department (ED).
Funding for the SBIRT programme comes from ACC, the Health Promotion Agency and Te Ara Oranga.
A trial undertaken in June 2016 saw patients that came through ED going through a screening process for substance abuse and social issues ranging from methamphetamine, cannabis, alcohol and tobacco use.
Between January 2018 and July 2019, 6719 screens were conducted on patients for substance use, with 172 self-reporting Methamphetamine use in the three months prior to being screened.
ED staff found they were able to focus on a group that may not have been identified before and offer treatment options and support services to them.
From there, the SBIRT programme became part of the regular ED process, and it has continued to successfully reach those that need support.
A pivotal element of the programme's ongoing success is the presence of Michelle Petricevich within the Department. Her role is to screen, engage with patients and provide an opportunity to discuss their substance use, offer support options and referral if desired.
Michelle has a background of social and health science and a wealth of experience working for government and non-government organisations. She also has her lived experience, which helps her work from the point of compassion and non-judgement.
Michelle says that she respects each person has their unique journey and giving them an understanding of the referral process and treatment pathways helps prepare them for recovery.
Intuitive iPad based software called Rataora assists her to engage ED patients in discussions about their substance use. Patients decide whether they'd like their whānau/friends involved, which develops a powerful pro-social connection in owning and acknowledging substance use for patients and their whānau.
If patients are not open to a straight referral, they are offered a supportive call from a psychologist and information on community support groups. Connecting services has helped improve outcomes for patients, reduced wait-times and enhanced service delivery and communication.
The referral team includes Northland DHB Alcohol and Other Drugs, The Salvation Army, the Meth Help team, Whangarei Youth Space, Alcohol Drug Helpline, Rubicon Youth and the Smokefree team.
Sixty three patients (37 percent of those using) reported a daily or weekly desire to use the drug. Sixty eight (40 percent) consented to a referral for support.
Five senior ED doctors recently provided feedback on the SBIRT and in particular, Michelle’s contribution to the programme. All commented that having the service was integral for the work that they do.
They said that it was a useful resource for all staff, provided opportunities for tapping into multidisciplinary care and raised awareness about alcohol and drug intervention and referral pathways in the Department.
They also noted Michelle’s ability to generate a rapport with some of the patients most in need of support, producing much better outcomes.
They highlighted that although their core job is to treat emergencies, they do have a responsibility to intervene and advocate for patients at any opportunity. However, they are often too busy to engage with the issues of drugs and alcohol fully.
Michelle however, has the time and skills to screen each patient and create a rapport that enables her to gain all the information required to assess their individual needs.
Michelle acknowledges the willingness and support of the Emergency Department team in the success of her role.
Whangarei ED clinical director Dr Marysha Gardner says that while they see the sick and injured in ED there are lots of other health concerns that come through the department.
“Medical conferences and literature are noting how important social justice aspects of healthcare are, and in Northland, we have the opportunity to try and do something that we were not previously equipped for.
“We are extremely grateful to have the screening and brief intervention role in ED because it adds so much more to what we do and what we can manage.”
Alcohol Drug Helpline 08007877897 / txt 8681 www.alcoholdrughelp.org.nz(external link)
Quitline 0800 778 778 www.quit.org.nz(external link)
Toki Rau 0508 8654 728 www.tokirau.co.nz
Depression Helpline 0800111757 / txt 4202 / www.Depression.org.nz(external link)