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What’s New in Screening and Assessment Tools? Florida Partners in Crisis: Annual Conference and Justice Institute July 13, 2011 Orlando, Florida Roger H. Peters, Ph.D., University of South Florida, Tampa, Florida; rhp@usf.edu. Goals of this Presentation. Review:

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Goals of this Presentation

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  1. What’s New in Screening and Assessment Tools? Florida Partners in Crisis: Annual Conference and Justice InstituteJuly 13, 2011 Orlando, Florida Roger H. Peters, Ph.D., University of South Florida, Tampa, Florida; rhp@usf.edu

  2. Goals of this Presentation Review: • How to access relevant resources • Challenges in selecting instruments • Available substance abuse, mental health, and related instruments

  3. Resources • CSAT TIP #42 and #44 • CMHS National GAINS Center • Council of State Governments • NIDA

  4. (GAINS Center, 2004; Steadman et al., 2009)

  5. Co-Occurring Substance Use Disorders 74% of state prisoners with mental problems also have substance abuse or dependence problems (U.S. Department of Justice, 2006)

  6. Importance of Screening and Assessment • High prevalence rates of mental and substance use disorders in justice settings • Persons with undetected disorders are likely to cycle back through the justice system • Allows for treatment planning and linking to appropriate treatment services

  7. Screening for MH and SA Disorders • Routine screening for both sets of disorders • Other important domains: trauma, motivation, criminal risk • Acute MH and SA symptoms: • Suicidal thoughts and behavior • Depression, hallucinations, delusions • Potential for drug/alcohol withdrawal • History of treatment, including use of meds • Determine need/urgency for referral

  8. Survey Results: SA Screening for Offenders • Wide variation in types of SA screening instruments administered • 32% of sites used no SA screening instruments • 42% of sites did not use a standardized SA screening instrument (Taxman et al., 2007)

  9. Challenges in Selecting Screening Instruments • Proliferation of screening instruments • Use of non-standardized instruments • Instruments not validated in CJ settings • Absence of comparative data • Direct to consumer marketing of instruments with poor psychometric properties (e.g., SASSI)

  10. Screening - Mental Health • Brief Jail Mental Health Screen • CODSI (Sacks et al, 2007) • Global Appraisal of Need (GAIN - SS) • Mental Health Screening Form - III • MINI - M

  11. Screening - Substance Abuse • TCU Drug Screen – II • Simple Screening Instrument • ASI – Alcohol and Drug Abuse sections • GAIN - SS

  12. Specialized Screens • BASIS-24 • Centre for Addiction and Mental Health Concurrent Disorders Screener (CAMH-CDS) • Psychiatric Diagnostic Screening Questionnaire (PDSQ)

  13. Instruments for Adolescents • CAFAS • GAIN • MAYSI-2 • PESQ • POSIT

  14. Other Screening Domains • Trauma and PTSD • Motivation • Criminal Risk

  15. Trauma and Victimization • Female offenders frequently have been victims of physical or sexual violence • Trauma history – should be expectation for women (and men) in justice settings • Impact of violence is widespread, can impair recovery from MH and SA disorders

  16. Trauma and PTSD Screening Issues • PTSD and trauma are often overlooked in screening • Other diagnoses are used to explain symptoms • Result – lack of specialized treatment, symptoms masked, poor outcomes

  17. Screening for Trauma and PTSD • All offenders should be screened for trauma history • Screening does not require mental health clinician nor discussion of specific details • Many public domain instruments available • Positive screens - referred for assessment

  18. Screening Instruments for Trauma and PTSD • Clinician-Administered PTSD Scale for DSM-IV (CAPS) • Impact of Events Scale (IES) • Primary Care PTSD Screen (PC-PTSD) • PTSD Checklist – Civilian Version (PCL-C) • Trauma Symptom Inventory (TSI)

  19. Instruments – Motivation and Stages of Change • CMRS • RCQ • SOCRATES • TCU Treatment Motivation Scales • URICA

  20. Assessment Instruments • Addiction Severity Index (ASI) • Global Appraisal of Needs (GAIN) • Texas Christian University – IBR • Brief Intake Interview • Comprehensive Intake

  21. Summary of Key Points • High rates of co-occurring MH/SA disorders • Blended screening and assessment approach needed • Key domains: MH, SA, trauma, criminal risk • Proliferation of instruments, but all instruments not created equal • Many evidence-based instruments available - Most in public domain - Easy to access and to administer

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