Symposium 37 - Implementing and Adapting Innovative Technology to Improve Mental Health, Substance Use, and Social Needs Screening and Referral to Treatment Tools Across Healthcare Settings

Chair(s)

• 

  Sara Witcraft, Ph.D. (she/her/hers)

  Assistant Professor
  Medical University of South Carolina
  Johns Island, SC, United States

Co-Chair(s)

• MH

  Marie Hayes, Ph.D. (she/her/hers)

  Assistant Professor and Clinical Psychologist
  Medical University of South Carolina
  Johns Island, SC, United States

Presenter(s)

• 

  Sara Witcraft, Ph.D. (she/her/hers)

  Assistant Professor
  Medical University of South Carolina
  Johns Island, SC, United States
• JP

  Jeffrey Pavlacic, Ph.D.

  Licensed Clinical Psychologist
  Medical University of South Carolina
  Charleston, SC, United States
• 

  Carla Danielson, Ph.D.

  Professor; Director of Postdoctoral Training
  Medical University of South Carolina
  Charleston, SC, United States

Most individuals experiencing mental health and substance use disorders will not seek help on their own or delay seeking care for many years (Han et al., 2017; Wang et al., 2005) due to multiple factors including unrecognized symptoms, limited access, racism, and stigma (Conner et al., 2010; SAMHSA, 2024; Walker et al., 2015). Healthcare settings are ideally positioned touchpoints to screen for mental health, substance use, and social needs and provide treatment referrals for patients who screen positive. However, patients are reluctant to disclose stigmatized experiences (e.g., intimate partner violence, poverty) and illegal behaviors (e.g., drug use), and marginalized patients experience compounded barriers to disclosure due to systemic factors (e.g., racism; Van Boekel et al., 2013). Further, medical providers often are uncomfortable assessing mental health and social needs and perceive not having enough time, training, or resources to adequately address such needs (Hall et al., 2015; Kirst et al., 2012; Sprague et al., 2012). Technology may reduce these patient and provider barriers by increasing comfort to disclose mental health, substance use, and social needs and enhance equity and eliminate bias through standardized screening, while reducing provider burden (Dar et al., 2023; Shaw et al., 2024).

This symposium illustrates three different, adaptable digital solutions for embedding screening and referral tools into routine care, including a tablet-based computer “provider,” a confidential patient screening and electronic health record (EHR)-integrated intervention, and a text/phone-based tool. These presentations will discuss integration of technology-enhanced screening/referral tools in a variety of settings and with diverse populations, including in trauma centers for substance use, primary care for intimate partner violence, and obstetrics for mental health and social drivers of health. Presenters will describe the implementation of each digital screening/referral tool, including demonstration of each tool, considerations for adaptation, and outcomes of the tool such as identification of problems and access to care.

The first presentation describes preliminary outcomes of a relational agent administered screening, brief intervention, and referral program for substance use among patients hospitalized for traumatic injuries (e.g., gunshot wound, motor vehicle collision). The second presentation details electronic medical record-integrated patient screening and physician intervention/referral tool for intimate partner violence across 15 primary care clinics. The final presentation will present a text-based screening and brief intervention and referral program for mental health and social drivers of health integrated into obstetric care.

Presenters bring experiences from a range of backgrounds to highlight the role of technology in screening and referral tools, including the utility of such tools for a variety of psychosocial issues. The discussant will draw on her experience with the design and large-scale implementation of technology-based screening and referral programs to provide recommendations for scaling and smooth integration of technology into routine healthcare settings.

Presentations:

• 11:33 AM - 11:52 AM CST

  (SYM 37) Leveraging Relational Agents to Improve Substance Use Screening, Brief Intervention, and Referral to Treatment in Trauma Centers
  

  Speaker: Theresa Skojec, Ph.D. – Medical University of South Carolina

  Co-Author: Sara Witcraft, Ph.D. (she/her/hers) – Medical University of South Carolina

  Co-author: Ebonie Powell, MA – Medical University of South carolina

  Co-author: Sarah German, B.A. – Medical University of South Carolina

  Co-author: Timothy Bickmore, PhD – Northeastern University

  Co-author: Leigh Ridings, PhD – Medical University of South Carolina

  Co-author: Bruce Crookes, MD – Medical University Of South Carolina

  Co-author: Kenneth Ruggiero, PhD – Medical University of South Carolina
• 11:52 AM - 12:11 PM CST

  (SYM 37) Examining Physician Responses to Positive Intimate Partner Violence (IPV) Screening in Primary Care Using an Electronic Health Record Facilitated Confidential Encounter Template
  

  Speaker: Megan Wallace, LISW-CP – Medical University of South Carolina

  Co-Author: Jeffrey Pavlacic, Ph.D. – Medical University of South Carolina

  Co-author: Sara Witcraft, Ph.D. (she/her/hers) – Medical University of South Carolina

  Co-author: Christine Hahn, PhD – Medical University of South Carolina

  Co-author: Kit Simpson, DrPH – Medical University of South Carolina

  Co-author: Jenna McCauley, Ph.D. – Medical University of South Carolina

  Co-author: Vanessa Diaz, M.D. – Medical University of South Carolina

  Co-author: Leslie Lenert, M.S., M.D., FACMI – Medical University of South Carolina