The 130th Annual Meeting of APHA

3138.0: Monday, November 11, 2002 - 1:24 PM

Abstract #38898

Implementing brief screening for co-occurring mental health symptoms, substance abuse, and trauma history: Tools and strategies

Jane M. Liebschutz, MD, MPH1, Alisa K Lincoln, PhD, MPH2, Daniel P. Dooley3, Hortensia Amaro, PhD4, and Luz M. Lopez, PhD Candidate3. (1) Section of General Internal Medicine Research Unit, Boston University School of Medicine, 91 East Concord Street, Suite 200, Boston, MA 02118, (2) Social and Behavioral Sciences Department, Boston University School of Public Health, 715 Albany Street, Boston, MA 02118, (617) 414-1387,, (3) Office of Research, Health Assessment and Data Systems, Boston Public Health Commission, 1010 Massachusetts Avenue, 6th Floor, Boston, MA 02118, (4) Northeastern University, Northeastern University, 360 Huntington Avenue, Stearns Building, 503, Boston, MA 02115

The high rates of co-occurring mental illness, substance abuse, and trauma suggest that substance abuse treatment programs should screen for the other conditions in order refer for further assessment and treatment services. One barrier to screening is the lack of a screening tool that can be administered by staff members with varied levels of clinical training. The Boston Consortium of Services for Families in Recovery (BCSFR) is a SAMHSA-sponsored study testing the effectiveness of integrating the treatment of trauma and mental assessments into four substance abuse treatment programs, all affiliated with the Boston Public Health Commission. The sites consist of one outpatient and two residential programs exclusively for women, and a coed methadone program. BCSFR developed such a screening tool by using existing validated measures for each condition. When such measures weren’t available, expert opinion or published but non-validated measures were used. After consumer input and pilot- testing, the tool was integrated into initial clinical assessments for female clients at the four BCSFR sites. Through December 2001, 285 completed screens revealed 95% of clients had experienced childhood or adult interpersonal violence and 80% experienced childhood physical or sexual abuse. Within the prior 30 days, 75% reported experiencing symptoms of depression, 67% anxiety and 17% suicidal ideation or self-harm. Comparisons of co-morbidity by treatment modality and race/ethnic groups will be presented. This tool promises to help identifying co-occurring conditions in substance abuse treatment programs. Implications and suggestions for use in other settings will be discussed.

Learning Objectives:

Keywords: Screening Instruments, Substance Abuse Treatment

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

Treatment for Persons with Co-Occurring Disorders

The 130th Annual Meeting of APHA