Mental health provider shortages and associated mental health service treatment gaps have led to recent initiatives to broaden the types of providers delivering mental health services in the USA. A key example is the Behavioral Health Support Specialist (BHSS), a supervised bachelor's-level mental health provider, introduced in Washington State in 2023. Yet there is limited understanding of how behavioral health organizations who may employ these new providers perceive the acceptability and feasibility of these new roles, though such perceptions have critical implications for successful rollout and uptake. The research team conducted semi-structured individual interviews with n = 18 staff at organizations delivering behavioral health services throughout Washington to understand staff perspectives on these roles as the first cohort approached graduation and prepared to enter the workforce. The research team identified four main themes related to anticipated acceptability and feasibility: (1) the introduction of a bachelor’s-level mental health provider role alongside existing behavioral health credentials was viewed as acceptable; (2) a lack of clear information on billing codes and financing could present an organizational barrier to uptake; (3) limited supervisor availability could present a barrier to feasibility at some organizations; and (4): high levels of burnout that exist among mental health providers could also present feasibility challenges for bachelor’s-level providers. Although findings suggest promise for ongoing bachelor’s-level mental health provider initiatives in Washington and other states, they also highlight several areas in which proactive implementation support may be needed to support successful introduction and sustainment of these roles.

The demand for behavioral health services continues to outpace the supply of the behavioral health workforce, resulting in many people seeking behavioral health services within their primary care practice. Collaborative Care is an effective, evidence-based model of behavioral health service integration into primary care. An extensive literature of randomized controlled trials exists, with much less published about the outcomes of Collaborative Care in real-world settings. This systematic review aims to describe and summarize results of the published literature regarding real-world implementation efforts of CoCM and suggests a reporting framework for future implementation efforts to better understand, compare, and evaluate CoCM programs. We searched articles in PubMed and Web of Science published between Jan 1st 2000-September 30th 2024. Eligibility criteria included the following: (1) conducted in the United States, (2) real-world implementation studies, (3) adult patient population, (4) demonstrated the main elements that define CoCM as outlined by Medicare, (5) information above was publicly available in the article or supplementary material. The definition of CoCM was selected based on major professional organizations and Center for Medicaid/Medicare Services (CMS) criteria for Collaborative Care billing codes. A total of 21 articles were included in this review. Overall, Collaborative Care programs were found to be clinically effective across a wide range of settings and populations. The most common clinical outcomes reported were depression response (a 50

Mental health provider shortages lead to substantial treatment gaps for mental health services worldwide, including throughout the United States. Task-sharing, in which providers with no or limited prior training in mental health care are trained to deliver psychological interventions, is a leading strategy to increase capacity, yet it has been under-utilized in the US to date. Recent legislative changes are starting to enable opportunities for task-sharing mental healthcare in the US. A leading example is Washington State’s introduction of the Behavioral Health Support Specialist (BHSS), a supervised bachelors-level mental health provider role. However, little is known about patient perspectives on task-sharing mental health care within US settings. Our study engaged potential future patients at two integrated care clinics ( n = 40) using mixed methods data collection (semi-structured individual interviews and brief structured surveys adapted from the acceptability and appropriateness sub-scales of the Mental Health Implementation Science Tools) to explore potential patient perspectives on the perceived acceptability and appropriateness of these reforms in the US. We identified three main qualitative themes: (1) Overall, potential patients reported that they perceived task-shared mental health care to be acceptable; (2) Potential patients reported familiarity with task-sharing from other clinical and community settings; and (3) Potential patients shared hesitations and questions that are important for implementers and educators to address. Quantitatively, most participants reported moderate to strong support for receiving care from a task-shared mental health provider. Given that legislative reform expanding care delivery via these roles is already well underway, our findings can help support successful implementation of a bachelor’s level mental health provider role. Though the scope of this bachelor’s level role is currently limited to Washington, other states are exploring introducing similar roles to their mental health workforce, so these findings may be applicable nationwide.

BACKGROUND:Collaborative Care is a key strategy to improve population mental health by leveraging the expertise of psychiatric providers to support team-based treatment in primary care settings. Novel continuing education models can support psychiatric workforce development in this emerging area. OBJECTIVE:Describe the design, implementation, and outcomes of an interprofessional continuing education program for community-based psychiatrists and advanced practice psychiatric providers in practice across Washington State. METHODS:The part-time fellowship consists of the following four components: online didactics, live skills workshops, a quality improvement learning collaborative, and individual mentorship. The rationale and design of each component is described. Principles of adult learning were incorporated throughout, emphasizing active learning approaches. Evaluation included application data, fellows' attendance and session evaluations, and fellow surveys at baseline, end of fellowship, and 6 months postfellowship. Descriptive statistics and paired t-tests were used. RESULTS:In the first 5 years, 60 individuals graduated, with 72% from a designated mental health professional shortage area. They supported care delivered by 186 care managers and 696 primary care providers. Attendance was strong (79-90%) and fellows rated didactic quality and relevance highly (mean 4.5 out of 5 [standard deviation 0.30] and 4.5 [standard deviation 0.41], n = 1355 evaluations [85% response]). Relative to baseline, at graduation, fellows had significantly higher confidence in 49 of 53 clinical, systems-based, and quality improvement skills assessed (68-95% response); however, attitudes were unchanged (77-87% response). At baseline, 76% of fellows never reviewed aggregate patient data, whereas upon graduation, 48% did so at least quarterly (83% response). Graduates launched at least 8 new Collaborative Care programs in rural practices. CONCLUSIONS:The Community-based Integrated Care Fellowship exemplifies an innovative model that meets the lifelong learning needs of practicing psychiatric providers. Graduates increased their skills and embarked on practice change. Continuing education can be delivered through flexible, employment-friendly modalities at larger scale than traditional full-time clinical fellowships. This program demonstrates how active learning strategies can be utilized to stimulate clinical practice change. Moreover, its structure serves as a model for other psychiatric subspecialties, such as geriatrics or addictions, where workforce development targeting providers in practice may be particularly valuable.

BACKGROUND:Suicide is a leading cause of death in US adolescents and adults. Caring Contacts - non-demanding messages of care and support - can significantly reduce suicide risk, but important implementation questions remain. Two-way Caring Contacts texts (CC2) (to which recipients can reply) have evidence of efficacy, but in practice health systems typically send one-way Caring Contacts texts (CC1) (to which recipients cannot reply). This manuscript describes the protocol for the Comparing Suicide Prevention Interventions to Guide Follow-up Care (SPRING) Trial. METHODS:The SPRING Trial is a pragmatic randomized controlled trial designed to compare the effectiveness of CC2 and CC1 versus UC, and to determine whether CC1 are noninferior to CC2 for preventing suicidal behavior. The sample includes 849 participants 12 years or older who screen positive for suicide risk and receive usual care at a primary care or behavioral health clinic. Participants are randomized 1:1:1 to CC2, CC1, or UC, with participants unaware of the alternative treatments. The state 988 crisis and suicide hotline delivers both active interventions and the feasibility of this model will be described. The primary outcome is suicidal behavior, measured using the Harkavy-Asnis Suicide Scale (HASS). Secondary outcomes include suicide attempts, suicidal ideation, ED utilization, hospitalization, and outpatient mental health treatment. Outcomes are assessed via surveys at baseline, 3, 6, and 12 months. DISCUSSION:CC2 is more operationally complex than CC1. If CC1 is non-inferior to CC2, it could more feasibly be implemented at scale, increasing access to effective suicide prevention care. Clinical trial registration The SPRING Trial is registered at ClinicalTrials.gov (NCT06128239).

We systematically assessed the presence and distribution of state-level policies, specifically statutes and regulations that were in effect as of July 1, 2022, related to training any occupational groups in suicide prevention. Utilizing legal epidemiology methods, we conducted a cross-sectional assessment of all 50 states and the District of Columbia. We identified 824 policies in our initial search and retained 477 in our final policy database. Policies were distributed across 5 occupational settings: educational (n = 142), behavioral health (n = 130), carceral (n = 111), primary and specialty care (n = 60), and other (n = 58). Fourteen policies pertained to multiple settings. On average, each state had 9.4 policies and covered 3 occupational settings. All states had at least 1 policy (minimum: 1; maximum: 42). Training occupational groups in suicide prevention is a widespread strategy, but significant variation exists across states, occupational settings, and specific occupational groups. Further research is necessary to determine whether this is an effective suicide prevention strategy at the population level. (Am J Public Health. 2025;115(10):1742-1752. https://doi.org/10.2105/AJPH.2025.308193).

The mental and behavioral health workforce shortage has hindered access to care in the United States, resulting in long waitlists for persons who need behavioral health care. Global models for task sharing, combined with U.S.-led studies of nonspecialists delivering interventions for depression and anxiety, support the development of this workforce in a stepped care system. This Open Forum highlights an innovative effort in Washington State to initiate a bachelor's-level behavioral health support specialist curriculum leading to credentialing to expand the mental health workforce and improve access to care for people with depression and anxiety.

BACKGROUND:The gold-standard treatment for opioid use disorder (OUD) is medication for OUD (MOUD). However, less than a quarter of people with OUD initiate MOUD. Expanding the Collaborative Care Model (CoCM) to include primary care patients with OUD could improve access to and initiation of MOUD. This paper presents the methods and baseline sample characteristics of a Hybrid Type 2a trial comparing the effectiveness of CoCM for OUD and co-occurring mental health symptoms (MHS) to CoCM for MHS only. METHOD:42 primary care clinics were cluster randomized and 254 primary care patients with OUD and elevated MHS were enrolled. Recruitment was terminated early by the Data and Safety Monitoring Board for futility. Participants completed research assessments at baseline, 3 months, and 6 months. The multiple primary outcomes were past-month number of days of nonmedical opioid use and SF12 Mental Health Component Summary (MCS) scores. RESULTS:MCS scores were over a standard deviation below the national mean (M = 34.5). Nearly half (47.6 %) of participants had previously overdosed in their lifetimes. Three quarters (76.0 %) were already being prescribed MOUD at baseline, only 30.4 % reported non-medical use of opioids, and only 33.9 % reported being bothered by opioid cravings. CONCLUSION:The unexpectedly high proportion of enrollees already prescribed MOUD at baseline indicates that most patients were in the maintenance rather than acute phase of treatment. Challenges identifying and enrolling patients in the acute phase of OUD treatment implies that intervention effectiveness will depend on its success preventing the discontinuation of MOUD rather than initiating MOUD.

Introduction Engagement is a critical component of successful treatment for opioid use disorder (OUD). However, rates of patient engagement in OUD treatment, especially in outpatient settings, are variable and often low. Little is known about the specific strategies members of primary care teams use to initiate and encourage ongoing participation in OUD treatment. In a national cohort of primary care clinics in the U.S., we explored the perspectives of primary care team members on the meaning of and approaches to OUD treatment engagement. Methods We conducted semi-structured interviews with 35 providers from multidisciplinary primary care teams in an existing national cohort of 13 clinics across seven states. Teams were delivering OUD treatment via the Collaborative Care Model, a model that combines primary care providers (PCP), behavioral health care managers (BHCM) and consulting psychiatric providers (CPP) in a structured way to provide patient-centered, team-based, and measurement-based care. Interview participants included 14 PCPs, 13 BHCMs, and 8 CPPs. Interviews asked open-ended questions about provider experiences and practices that aided or hindered patient engagement in OUD treatment. Interview transcripts were double-coded by trained qualitative researchers and analyzed using a combination of deductive and inductive approaches to identify themes. Results Two themes emerged that describe provider perspectives on the meaning of engagement: 1) qualifying engagement by the volume of contact with patients, and 2) the need for more multidimensional measures of engagement. Six themes emerged that characterized provider engagement practices: 1) creating an environment of disclosure, 2) normalizing OUD treatment, 3) offering gentle but persistent outreach, 4) providing human connection and encouragement, 5) tailoring treatment to patient needs, and 6) avoiding stigmatizing responses. Analysis identified multiple replicable strategies that providers used to support these engagement practices. Conclusions Providers consistently apply a range of strategies when trying to engage patients in OUD treatment. Specific engagement strategies used embodied compassion and pragmatism, hallmarks of patient-centered care. Further research is needed to understand the impact of scaling engagement approaches across all care settings.

Background There is a growing interest in practice-based implementation research, yet too often research prioritizes and is most successful in academic settings. During a national implementation trial to evaluate the effectiveness of Collaborative Care for co-occurring opioid use and mental health disorders, we lost three of our 11 participating implementation sites, all representing community sites. Method To better understand needed supports for implementation trial participation, we conducted exit interviews ( n = 5) with key staff at these community sites. Interview transcripts were double-coded and analyzed using Rapid Assessment Process. Qualitative themes were iteratively reviewed by the study team. Results Three themes emerged characterizing challenges for community sites, including that: (1) research threatens sites’ most precious resource—staff; (2) staff lack comfort with and skills for research; and (3) research participation in its current form does not offer a clear return on investment. Conclusions Learnings from this work illuminate some of the barriers community sites face when trying to participate in multisite implementation research. An undercurrent of participant perspectives was the belief that community sites like theirs are just not set up to successfully participate in clinical trial research, including population-based implementation trials. Future implementation trials should consider strategies that disrupt traditional approaches, increasing the equitable inclusion of diverse practice settings in implementation research.

BackgroundOpioid use disorder (OUD) care engagement rates in primary care (PC) settings are often low. Little is known about PC team experiences when delivering OUD treatment and potential factors that influence their capacity to engage patients in treatment. Exploring PC team experiences may inform needed supports that can optimize OUD care delivery and improve outcomes for patients with OUD.ObjectiveWe explored multidisciplinary PC team perspectives on barriers and facilitators to engaging patients in OUD treatment.DesignQualitative study using in-depth interviews.ParticipantsPrimary care clinical teams.ApproachWe conducted semi-structured interviews (n = 35) with PC team members involved in OUD care delivery, recruited using a combination of criterion and maximal variation sampling. Data collection and analysis were informed by existing theoretical literature about patient engagement, specifically that patient engagement is influenced by factors across individual (patient, provider), interpersonal (patient-provider), and health system domains. Interviews were professionally transcribed and doubled-coded using a coding schema based on the interview guide while allowing for emergent codes. Coding was iteratively reviewed using a constant comparison approach to identify themes and verified with participants and the full study team.Key ResultsAnalysis identified five themes that impact PC team ability to engage patients effectively, including limited patient contact (e.g., phone, text) in between visits, varying levels of provider confidence to navigate OUD treatment discussions, structural factors (e.g., schedules, productivity goals) that limited provider time, the role of team-based approaches in lessening discouragement and feelings of burnout, and lack of shared organizational vision for reducing harms from OUD.ConclusionsWhile the capacity of PC teams to engage patients in OUD care is influenced across multiple levels, some of the most promising opportunities may involve addressing system-level factors that limit PC team time and collaboration and promoting organizational alignment on goals for OUD treatment.

Background: Suicide is a leading cause of death in adolescents and adults in the US. Follow-up support delivered when patients return home after an emergency department (ED) or primary care encounter can significantly reduce suicidal ideation and attempts. Two follow-up models to augment usual care including the Safety Planning Intervention have high efficacy: Instrumental Support Calls (ISC) and Caring Contacts (CC) two-way text messages, but they have never been compared to assess which works best. This protocol for the Suicide Prevention Among Recipients of Care (SPARC) Trial aims to determine which model is most effective for adolescents and adults with suicide risk. Methods: The SPARC Trial is a pragmatic randomized controlled trial comparing the effectiveness of ISC versus CC. The sample includes 720 adolescents (12-17 years) and 790 adults (18+ years) who screen positive for suicide risk during an ED or primary care encounter. All participants receive usual care and are randomized 1:1 to ISC or CC. The state suicide hotline delivers both follow-up interventions. The trial is single-masked, with participants unaware of the alternative treatment, and is stratified by adolescents/adults. The primary outcome is suicidal ideation and behavior, measured using the Columbia Suicide Severity Rating Scale (C-SSRS) screener at 6 months. Secondary outcomes include C-SSRS at 12 months, and loneliness, return to crisis care for suicidality, and utilization of outpatient mental health services at 6 and 12 months. Discussion: Directly comparing ISC and CC will determine which follow-up intervention is most effective for suicide prevention in adolescents and adults.

BACKGROUND:The U.S. Preventive Services Task Force recommends routine population-based screening for drug use, yet screening for opioid use disorder (OUD) in primary care occurs rarely, and little is known about barriers primary care teams face.OBJECTIVE:As part of a multisite randomized trial to provide OUD and behavioral health treatment using the Collaborative Care Model, we supported 10 primary care clinics in implementing routine OUD screening and conducted formative evaluation to characterize early implementation experiences.DESIGN:Qualitative formative evaluation.APPROACH:Formative evaluation included taking detailed observation notes at implementation meetings with individual clinics and debriefings with external facilitators. Observation notes were analyzed weekly using a Rapid Assessment Process guided by the Consolidated Framework for Implementation Research, with iterative feedback from the study team. After clinics launched OUD screening, we conducted structured fidelity assessments via group interviews with each site to evaluate clinic experiences with routine OUD screening. Data from observation and structured fidelity assessments were combined into a matrix to compare across clinics and identify cross-cutting barriers and promising implementation strategies.KEY RESULTS:While all clinics had the goal of implementing population-based OUD screening, barriers were experienced across intervention, individual, and clinic setting domains, with compounding effects for telehealth visits. Seven themes emerged characterizing barriers, including (1) challenges identifying who to screen, (2) complexity of the screening tool, (3) staff discomfort and/or hesitancies, (4) workflow barriers that decreased screening follow-up, (5) staffing shortages and turnover, (6) discouragement from low screening yield, and (7) stigma. Promising implementation strategies included utilizing a more universal screening approach, health information technology (HIT), audit and feedback, and repeated staff trainings.CONCLUSIONS:Integrating population-based OUD screening in primary care is challenging but may be made feasible via implementation strategies and tailored practice facilitation that standardize workflows via HIT, decrease stigma, and increase staff confidence regarding OUD.

LettersOctober 2023Does Screening for Opioid Use Disorder in Primary Care Increase the Percentage of Patients With a New Diagnosis?John C. Fortney, PhD*, Anna D. Ratzliff, MD, PhD*, Brittany E. Blanchard, PhD, Morgan Johnson, MS, Lori Ferro, MHA, Elizabeth J. Austin, PhD, Emily C. Williams, PhD, Mark H. Duncan, MD, Joseph O. Merrill, MD, Jennifer Thomas, MD, Brandon Kitay, MD, Michael Schoenbaum, PhD, Patrick J. Heagerty, PhD, Andrew J. Saxon, MDJohn C. Fortney, PhD*Department of Psychiatry and Behavioral Sciences, School of Medicine, University of Washington; Advancing Integrated Mental Health Solutions (AIMS) Center, University of Washington; and Center of Innovation for Veteran-Centered and Value-Driven Care, Health Services Research & Development, VA Puget Sound, Seattle, WashingtonSearch for more papers by this author, Anna D. Ratzliff, MD, PhD*Department of Psychiatry and Behavioral Sciences, School of Medicine, University of Washington, and Advancing Integrated Mental Health Solutions (AIMS) Center, University of Washington, Seattle, WashingtonSearch for more papers by this author, Brittany E. Blanchard, PhDDepartment of Psychiatry and Behavioral Sciences, School of Medicine, University of Washington, Seattle, WashingtonSearch for more papers by this author, Morgan Johnson, MSDepartment of Psychiatry and Behavioral Sciences, School of Medicine, University of Washington, Seattle, WashingtonSearch for more papers by this author, Lori Ferro, MHADepartment of Psychiatry and Behavioral Sciences, School of Medicine, University of Washington, Seattle, WashingtonSearch for more papers by this author, Elizabeth J. Austin, PhDDepartment of Health Systems and Population Health, School of Public Health, University of Washington, Seattle, WashingtonSearch for more papers by this author, Emily C. Williams, PhDDepartment of Health Systems and Population Health, School of Public Health, University of Washington, and Center of Innovation for Veteran-Centered and Value-Driven Care, Health Services Research & Development, VA Puget Sound, Seattle, WashingtonSearch for more papers by this author, Mark H. Duncan, MDDepartment of Psychiatry and Behavioral Sciences, School of Medicine, University of Washington, Seattle, WashingtonSearch for more papers by this author, Joseph O. Merrill, MDDepartment of Medicine, School of Medicine, University of Washington, Seattle, WashingtonSearch for more papers by this author, Jennifer Thomas, MDMorris Hospital and Healthcare Centers, Morris, IllinoisSearch for more papers by this author, Brandon Kitay, MDDepartment of Psychiatry and Behavioral Sciences, School of Medicine, Emory University, Atlanta, GeorgiaSearch for more papers by this author, Michael Schoenbaum, PhDNational Institute of Mental Health, Bethesda, MarylandSearch for more papers by this author, Patrick J. Heagerty, PhDDepartment of Biostatistics, School of Public Health, University of Washington, Seattle, WashingtonSearch for more papers by this author, Andrew J. Saxon, MDDepartment of Psychiatry and Behavioral Sciences, School of Medicine, University of Washington, and Center of Excellence in Substance Addiction Treatment and Education, VA Puget Sound, Seattle, WashingtonSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/M23-1369 Annals Author Insight Video - Jennifer Thomas, MD In this video, Jennifer Thomas, MD, offers additional insight into the article, "Does Screening for Opioid Use Disorder in Primary Care Increase the Percentage of Patients With a New Diagnosis?" (Duration 3:42) SectionsSupplemental MaterialAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Background: Integrating care for common mental health disorders into primary care through screening and treatment has proved to be highly effective and is now a widespread practice. Primary care may also be an ideal setting to offer treatment for opioid use disorder (OUD), as primary care providers make up the bulk of buprenorphine prescribers (1). However, substance use disorders often go unrecognized in primary care. Screening may be an effective approach to increase identification of OUD, as it is for depression, anxiety, and alcohol use disorder (2, 3). The U.S. Preventive Services Task Force recommends screening for substance use in ...References1. Stein BD, Saloner B, Schuler MS, et al. Concentration of patient care among buprenorphine-prescribing clinicians in the US. JAMA. 2021;325:2206-2208. [PMID: 34061152] doi:10.1001/jama.2021.4469 CrossrefMedlineGoogle Scholar2. Gilbody S, Sheldon T, House A. Screening and case-finding instruments for depression: a meta-analysis. CMAJ. 2008;178:997-1003. [PMID: 18390942] doi:10.1503/cmaj.070281 CrossrefMedlineGoogle Scholar3. Lee AK, Bobb JF, Richards JE, et al. Integrating alcohol-related prevention and treatment into primary care: a cluster randomized implementation trial. JAMA Intern Med. 2023;183:319-328. [PMID: 36848119] doi:10.1001/jamainternmed.2022.7083 CrossrefMedlineGoogle Scholar4. Austin EJ, Briggs ES, Ferro L, et al. Integrating routine screening for opioid use disorder into primary care settings: experiences from a national cohort of clinics. J Gen Intern Med. 2023;38:332-340. [PMID: 35614169] doi:10.1007/s11606-022-07675-2 CrossrefMedlineGoogle Scholar5. Oga EA, Mark K, Peters EN, et al. Validation of the NIDA-modified ASSIST as a screening tool for prenatal drug use in an urban setting in the United States. J Addict Med. 2020;14:423-430. [PMID: 32032210] doi:10.1097/ADM.0000000000000614 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAuthors: John C. Fortney, PhD; Anna D. Ratzliff, MD, PhD; Brittany E. Blanchard, PhD; Morgan Johnson, MS; Lori Ferro, MHA; Elizabeth J. Austin, PhD; Emily C. Williams, PhD; Mark H. Duncan, MD; Joseph O. Merrill, MD; Jennifer Thomas, MD; Brandon Kitay, MD; Michael Schoenbaum, PhD; Patrick J. Heagerty, PhD; Andrew J. Saxon, MDAffiliations: Department of Psychiatry and Behavioral Sciences, School of Medicine, University of Washington; Advancing Integrated Mental Health Solutions (AIMS) Center, University of Washington; and Center of Innovation for Veteran-Centered and Value-Driven Care, Health Services Research & Development, VA Puget Sound, Seattle, WashingtonDepartment of Psychiatry and Behavioral Sciences, School of Medicine, University of Washington, and Advancing Integrated Mental Health Solutions (AIMS) Center, University of Washington, Seattle, WashingtonDepartment of Psychiatry and Behavioral Sciences, School of Medicine, University of Washington, Seattle, WashingtonDepartment of Health Systems and Population Health, School of Public Health, University of Washington, Seattle, WashingtonDepartment of Health Systems and Population Health, School of Public Health, University of Washington, and Center of Innovation for Veteran-Centered and Value-Driven Care, Health Services Research & Development, VA Puget Sound, Seattle, WashingtonDepartment of Medicine, School of Medicine, University of Washington, Seattle, WashingtonMorris Hospital and Healthcare Centers, Morris, IllinoisDepartment of Psychiatry and Behavioral Sciences, School of Medicine, Emory University, Atlanta, GeorgiaNational Institute of Mental Health, Bethesda, MarylandDepartment of Biostatistics, School of Public Health, University of Washington, Seattle, WashingtonDepartment of Psychiatry and Behavioral Sciences, School of Medicine, University of Washington, and Center of Excellence in Substance Addiction Treatment and Education, VA Puget Sound, Seattle, WashingtonDisclaimer: The statements presented in this article are solely the responsibility of the authors and do not necessarily represent the views of the National Institutes of Health (NIH).Financial Support: This work was supported by the National Institute of Mental Health (NIH/NIMH; grant UF1MH121942). Dr. Blanchard was supported by University of Washington’s Institute of Translational Health Sciences KL2 Program through the National Center for Advancing Translational Sciences of the NIH (KL2TR002317) and the National Institute on Drug Abuse Loan Repayment Program (L30DA056956).Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M23-1369.Data Sharing Statement: The authors have indicated they will not be sharing data. The data represent counts of patients diagnosed with OUD from 20 clinics. Data from individual patients collected as part of the larger clinical trial will be made available in a public use data set.Corresponding Author: John C. Fortney, PhD, Department of Psychiatry, University of Washington, 1959 NE Pacific Street, Box 356560, Seattle, WA 98195; e-mail, fortneyj@uw.edu.This article was published at Annals.org on 17 October 2023.* Drs. Fortney and Ratzliff served as co–primary authors of the manuscript. PreviousarticleNextarticle Advertisement Annals Author Insight Video - Jennifer Thomas, MD In this video, Jennifer Thomas, MD, offers additional insight into the article, "Does Screening for Opioid Use Disorder in Primary Care Increase the Percentage of Patients With a New Diagnosis?" (Duration 3:42) FiguresReferencesRelatedDetails Metrics October 2023Volume 176, Issue 10 Page: 1431-1433 Keywords Drug screening Health screening Opioid use disorder Opioids Psychiatry and mental health Psychometrics ePublished: 17 October 2023 Issue Published: October 2023 Copyright & PermissionsCopyright © 2023 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...