A New Screening Procedure to Identify Co-Occurring Psychiatric and Substance Use Disorders

Abstract

It is estimated that 24% of persons served by community mental health agencies have a co-occurring psychiatric and substance use disorder (COPSD). Up to 50% of persons with substance abuse have co-occurring post-traumatic stress disorder (co/PTSD). A failure remains in objectively identifying this population in everyday practice. At a community mental health agency serving rural East Texas, a new Screening-Into-Intake Procedure (SIIP) for adults initiating services was implemented using the Iowa Model for Evidence-Based Practice. Implemented in four stages, this SIIP incorporated both self- and observer-rated screening instruments to assist in identifying and provisionally diagnosing post-traumatic stress disorder (PTSD), COPSDs, and co/PTSD. Using the Chi-square test, an average rate of 21% true positive PTSD diagnoses were identified between the screening and diagnostic stages of the intake process. However, for an average of 25.5% of persons, PTSD diagnosis remained inconclusive and unidentified. Due to the limited sample size of data collected, most results regarding the COPSD and co/PTSD diagnoses were statistically insignificant. While the SIIP intervention raised agency awareness about assessing PTSD and COPSDs within its population, their identification remains elusive. Screener competency in SIIP use was identified as a primary factor in both SIIP effectiveness and disorder identification.