Sepsis Bundles: Impact on Mortality and Patient Outcomes
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.
Keywords: co-occurring psychiatric and substance use disorder (COPSD), post-traumatic
stress disorder (PTSD), measurement-based care, screening.