Screening and Assessment

Integrated Screening and Assessment

Effectively serving individuals with co-occurring mental and substance use disorders requires integrated screening and assessment processes.

Integrated screening is screening that occurs for both disorders. It is a brief process that occurs soon after the individual seeks services. It indicates whether the individual is likely to have a substance use disorder and at least one co-occurring mental disorder. Individuals who screen positive for co-occurring disorders should receive an indepth assessment.

Integrated assessment means that mental and substance use disorders are assessed in the context of each other. It consists of gathering key information and engaging in a process with the individual that enables a practitioner to:

• Establish (or rule out) the presence or absence of a co-occurring disorder
• Determine the individual's readiness for change
• Identify the individual's strengths or problem areas that may affect the processes of treatment and recovery
• Begin the development of an appropriate treatment relationship

Indepth assessments provide information that is used by the practitioner and the individual to create a treatment plan. It is also useful to establish a baseline of signs, symptoms, and behaviors that can be used to monitor progress over time for individuals with co-occurring disorders.

Integrated screening and assessment should occur when an individual enters either service system. It can be conducted by the same practitioner or by different practitioners. Also, an individual who screens positive for co-occurring disorders may be seen at the same or a different agency for an integrated assessment.

Development of integrated screening and assessment capacities requires:

• Consideration of instruments to be used for each
• Development of policies and procedures identifying when screening and assessment will occur, in which agencies and by which staff
• Consideration of system level issues such as referrals, information sharing, data collection, staff training and financing.

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Resources and Links

• Screening, Assessment and Treatment Planning for Co-Occurring Disorders Overview Paper 2

  This SAMHSA white paper gives an overview of integrated screening, assessment, and treatment planning for persons with co-occurring disorders of substance abuse and mental illness. Discusses staffing, protocols, methods, systems issues, financing, and client-centered services.

• TIP 42 Appendix G Screening and Assessment Instruments

  An overview of COD assessment with recommended instruments and considerations for treatment

• Screening for Co-occurring Disorders

  Guidance for screening tool selection

• Hazelden Overview of Co-occurring Disorder Screening Tools

  Review and links to frequently used screening tools

• Co-occurring Joint Action Council Screening Tool (CST)

  Easily administered COD screening tool

• Screening for the Possibility of Co-occurring Mental Illness and Substance Use Disorder in the Behavioral Health Setting

  Discussion of construct for effective COD screening tools

• The AC-OK Screen for Co-Occurring Disorders (Mental Health, Trauma Related Mental Health Issues & Substance Abuse): What a Difference 5 Minutes Can Make

  Readily administered COD screening tool

• Co-occurring Disorder-Related Quick Facts: Cognitive and Physical Disabilities

  A brief fact sheet explaining cognitive and physical disabilities and their relation to co-occurring disorder

• Co-occurring Disorder-Related Quick Facts: Physical Health

  A brief fact sheet explaining chronic health problems in the context of co-occurring mental health and substance use disorders

• Technical Assistance (TA) Report for the Co-occurring State Incentive Grants (COSIGs)

  Overview of goals, strategies, and tools for screening for co-occurring disorders

• Overview of the ASAM Patient Placement Criteria, Second Edition Revised (ASAM PPC-2R)

  Concise introduction and review of widely-used assessment tool

• Assessment: Technical Assistance (TA) Report for the Co-occurring State Incentive Grants (COSIGS)

  Explains use of assessment tool in step-by-step format