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

PROJECT GOALS

            This project aims to validate the MINI, a screen for mental health problems, and the DALI, a screen for substance use problems, for culturally heterogeneous populations in substance abuse and mental health treatment settings and in non-traditional settings such as jails, shelters, outreach and primary care programs.  


  RESEARCH ACTIVITIES AND RESULTS

Method: Data collection has been completed and cut points established on the MINI screen to identify psychiatric co morbidity in traditional chemical dependency settings. Data collection was completed for the DALI screen, and analyses to develop cut points to identify co morbid substance abuse problems are proceeding. Validation criteria included 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 included the screens themselves, level of function and disability information, severity of mental health problems, and service utilization for the prior six-month period.

Results: Project results and expertise (a screening and assessment module for a web based curriculum) were included in technical assistance provided by the SAMHSA funded National GAINS Center to jail diversion programs that target women with trauma histories and co occurring disorders

POLICY IMPLICATIONS

Routine assessment of risk for co-occurring disorders has been inconsistently implemented due to lack of staff resources and procedures for integrating the requirements of two separate state regulatory agencies (NYS OMH and NYS 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

Analysis of the full data set is ongoing. NYS OASAS is developing a manual to train clinical staff in use of the screen and plans a pilot implementation of the screen with “opinion leader” settings. For the DALI screen, cut points will be defined using ROC analysis, a manual will be developed in conjunction with the NYS OMH, and the screen will be implemented in the OMH statewide ACT Team initiative.
Project investigators continue to participate in the NYS Inter Agency Work Group on Co occurring Disorders, and will provide expertise in screening and assessment in an application for a SAMHSA funded Technical Advisory Center aimed at supporting states to develop a rational approach to system change and best practice implementation for co occurring disorders.

INCLUSION  OF GENDER AND MINORITY SUBJECTS

 

 

Amer Indian  Alaska

Native

Asian,

Pacific Islander

Black, not Hispanic 

Hispanic

White, not  Hispanic

Unknown

Origin

TOTAL

Female

4 (50%)

2 (67%)

202 (43%)

93 (45%)

68 (41%))

24 (41%)

393 (43%)

Male

4 (50%)-

1 (33%)-

264 (56%))

111 (54%)

95 (58%)

28 (45%)

503 (55%)

Missing

-

-

3 (1%)

1 (1%)

1 (1%)

8 (14%)

13   (1%)

Total

8 (1%)-

3 (<1%)-

469 (52%)

205 (23%)

164 (18%)

60 (7%)

909 (100%)

 

Entered: July 17, 2001
Updated: July 1, 2003 

 

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