Screening for Co-occurring Disorders
Updated June 2002

Principal Investigators:  Mary Jane Alexander, Ph.D. Co-PIs: Gary Haugland, M.A., 
Isaac Koilpilloi, M.D., Frank McCorry, Ph.D. 

Routine assessment of risk for co-occurring disorders has been difficult to implement due to lack of staff resources and procedures for integrating the requirements of two separate state regulatory agencies (OMH and OASAS). This project is an initiative of the Center in conjunction with both of those agencies to remedy this important gap in the provision of adequate services for PSMD with severe substance use problems. 


  RESEARCH ACTIVITIES AND RESULTS

Methods: Data collection for the MINI screen was completed for traditional chemical dependency settings and is in progress in jails and shelters.  Because data collection was in progress at the time of the September 11 attack on the World Trade Center, we  added items to the protocol to ask participants about their exposure to these events, the impact of the events on their mental health and substance abuse problems, and whether and where they had sought assistance for these problems.  Data collection is in progress for the DALI screen.  Interviewer and computer assisted MINI and DALI screens may be administered in English or Spanish to study participants. Validation criteria include Structured Clinical Interviews for Diagnosis for both screens, with state of the art biological criteria and collateral interviews enhancing the self-report of substance use and impairment for the DALI.  The screen protocols include the screen itself, level of function and disability information, severity of mental health problems, and service utilization for the prior and prospective six-month period.

POLICY IMPLICATIONS

Routine assessment of risk for co-occurring disorders has been difficult to implement due to lack of staff resources and procedures for integrating the requirements of two separate state regulatory agencies (OMH and OASAS). This project, a collaborative initiative of the Center, OMH and OASAS, may serve to remedy this important gap in identification and will enhance the likelihood of providing adequate services for PSMD with substance use problems. 

PLANS

The validation studies will be completed in the next six months.   If psychometric properties are acceptable, cut points will be defined for screens using Receiver Operating Curve (ROC) analysis.  In a co-related effort, we will continue to seek federal or foundation funding to evaluate a (state funded) local demonstration of a broad policy initiative to support the delivery of integrated services for co-occurring disorders that includes routine implementation of validated screens on case identification as well as clinician cross training, personnel resources to coordinate needed services and regulatory relief.  Drs. Alexander, McCorry and Koipillai will continue to participate in the training activities of the policy initiative.

INCLUSION  OF GENDER AND MINORITY SUBJECTS

Entered: July 17, 2001
Updated: June 17, 2002 

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