Screening and Assessment of Co-Occurring Disorders in the Justice System

Screening and Assessment of Co-Occurring Disorders in the Justice System examines screening and assessment tools and approaches to identify mental and/or substance use disorders among individuals who are justice involved. This monograph serves as a resource for those who encounter justice-involved individuals across all intercepts of the Sequential Intercept Model and are interested in implementing effective programs to assist them. The document identifies critical issues in screening and assessing co-occurring disorders in the justice system, instruments for screening and assessing co-occurring disorders, and additional resources for suggested reading. Several of the evidence-based tools are available under the public domain, as is this report.

Screening provides a brief review of symptoms, behaviors, and other salient background information that may indicate the presence of a mental health or substance use disorder. Screening results are used to determine the need for further assessment.

Assessment provides a lengthier and more intensive review of mental health, substance use, or co-occurring disorders that can lead to diagnoses and placement in different types or levels of treatment and supervision services.

The justice system lacks built-in mechanisms for personnel to identify justice-involved individuals with CODs. To promote more positive outcomes and reduce the risks of recidivism, individuals with CODs should be identified at the earliest point in the justice system to gain access to mental health and substance use treatment services. Screening and assessment results are critically important in matching individuals to appropriate types of services, and to levels of intensity, scope, and duration of those services.

Key issues to be aware of in developing screening and assessment protocols include the failure to examine one or more of the disorders comprehensively, inadequate staff training to identify and assess disorders, divided mental health and substance use screening services and assessments, ineffective or non-standardized instruments in identifying CODs, and absence of management information systems.

This resource was first shared in 2015 and revised in 2019.

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