Comment - Shelton

OMB No. 0930-XXXX
Expiration Date X)VX)VXXXX

(!DU),aSrtheii.,
as tnelr
programsuse
heatment,prog!?mq
use{he.Ser-vice,Detivery.Unit
the Servlceljellvery Unlt (SlJU)
abusetreatment
abuse
substance
Currently,substance
Program: Currently,
Program:
progtu- definition for the National S"-ey of SubstanceAbuse Treatment Services. Mental health treatment
proitu*r usefacility ot,oiganiZ"U.nl" liiottlng fOrtUe,SUi#yof Vfental,H,ealth.Orgmzatiotts,,lGe"etall
Gganizatioil (.SMUOI,. ., :,.,, ; : ,
il".pitut MentalHealthse ies, andManaged.,Behanitiiai,,Heattn.Cari

establish the need for an in-depth assesiment. Screening i

iSbirlef,
and:oqgurg
irnat,plbgess,t!1t,tjdcb]ly,

Assessmentis a formal piocess,ihatmay,involVe clinical inteiviews, administrationof standardizedinstruments,
and/or,review of eiisting inflormation, For i nstance,ii reasonablyclrn'entand credibleassessntent
infonnationis

disorders.
is NOT required,],
[a specificdiagnosis
i

,

, , ,:,,

::::.,

,

'
,i ,

,,

plan.,,.,The
a Resultsusedih:,treaftnent
assessment
resultsmustioutinetylt-. lnCtUOea,

[ASSESSMENTIS.sUB.s.TqNIED:INToi..INTAKE,?:]INow.SVSTnu:ii:'::... ml

medicaVclinichl

SCREENING,ASSESSMENT,AND TREATMENT

What type of services does this program/SDUlfacllitylorganization provide? fMark X to one onl-v]
tr

Mental Health

n

SubstanceAbuse

t]

IntegratedMental Health and SubstanceAbuse Co-occurringProgram

N O T E : P l e a s ei n c l u d eo n l v c l i e n t st h a t e n t e ry o u r f a c i l i t y / o r g a n i z a t i oi n t h e u p c o m i n gp e r i o c (l e . g . t, r v o
months betrveenxxx and yyy 2006)

n.

Number of clients/patients/consumers
seen
from {date X} to {months from dateX}

SCREENING
Screenedfor both mental and substanceuse disorders
number of clients/patients/consumersscreened for

mental and substanceuse disorders.

81.

Number of theseclients/patients/consumerswho screenedpositive for both mental and
substanceuse disorders (i.e. screenedpositive for co-occuting disorders).

B.2.

Number who screenedpositive for a mental disorder andnegative for a substanceuse
disorder.

B3.

Number who screenedpositive for a substanceuse disorder and negative for mental
disorder.

84.

Number who screenednegative for both mental and substanceuse disorders.

Screenedonly for a substanceuse disorder; no screenfor a mental disorder
.0' FOR US.l
ITHIS WOULD BE
Number of clients/patients/consumersscreenedonly for a substanceabusedisorder.
C.

c1.

Number withpositiva screenfor a substanceuse disorder.

c2.

Number with negative screenfor a substanceuse disorder.

Screenedonlv for a mental disordert no screen for a substanceuse disorder [THIS WOULD BE ,00.1

D.

Number of clients/patients/consumersscreened only for a mental disorder.

Dl.

Number withpositive screenfor a mental disorder.

D2,

Number with negative screenfor a mental disorder.

Not screenedfor either tvpe of disorder [THIS WOULD BE '0'l

E.

rnenialaisoideti
sii:eCniofor'aiiiie"l.siitrilanCe'nte'oi
Numberof clients/patientS/poiitdin'e-is'iio'f

El.

for both
reportedin item E who were directly assessed
Numberof clientsipatients/consumers
mental and substanceusedisorders.

F'2.

reportedin item E who were directly assessedfor a
Number of clients/patients/consumers
Ltsedisor.lcr.
rnent:rldisorderbLrtnot for a sr-rbstal-)ce

E3.

reportedin item E who were directly assessedfor a
Number of clients/patients/consumers
but
not
for
a
mental
disorder.
substanceuse disorder

reportedin item E who were not directly assessedfor
Number of clients/patients/consumers
either substanceuse or mental disorders. IDOES THIS MEAN PEOPLE THAT WERE
REFERRED BUT NEVER SEEN?]

F.4,

ASSESSMENT

F.

G.

H.

Total number of clients/patients/consumersassessedfor both mental disorder and substance
for both disorders,whetheror not they were
use disorder. [NOTE: Include all personsassessed
screened.l[THIS WOULD BE EVERYONE.]
Fl.

Number withpositive assessmentsfor both.

F2,

Number withpositive assessmentfor mental disorder andnegative assessmentfor
substanceusedisorder.

F3.

Number with positive assessmentfor substanceuse disorder and negative assessmentfot
mental disorder.

F4,

Number with negative assessmentsfor both.

Total number of clients/patients/consumersassessedfor a mental disorder but not for a
for a mental disorder,whether
substanceuse disorder. [NOTE: Include all personsassessed
or not they were screened.]['0']

Gl.

Number with positive assessmentsfor mental disorder.

G2.

Number with negative assessmentsfor mental disorder.

for a substanceuse disorder but not for a
assessed
Total number of clients/patients/consumers
for a substanceuse disorder,whether or
mental disorder. INOTE: Include all personsassessed
not they were screened.]['0']

I.

Hl._Number

withpositive assessments
for substanceuse disorder.

H2. _Number

with negativeassessments
for substanceuse disorder-

not assessedfor either a mental or a substanceuse disorder.
Number of clients/patients/consumers

TIAVE CO-OCCURRING DISORDER

J. _

Number of clients/patients/consumers
detenninedto have co-occurringdisorderthrough a formal
process of assessment.ITHIS WOULD DEPEND ON A QUERY.]

K. _

Numberof clients/patients/consumers
detenlined to have co-occuring disorderthrough
processesttot nrcetittgthe tlresltold clefirtitiottof assessnrcril.
ISCREENING ONLY?]

L. _

Number of clients/patients/consumers
determinednot to have co-occurringdisorder.

TREATMENT

M._

Number of clients/patients/consumers
admitted to treatment at your program for co-occurring
disorder.
M1._

Number of clients/patients/consumers
treatedfor co-occurringdisorderwith minimal
coordination

iM2._Number
of clients/patients/consumers
treatedfor co-occurringdisorderwithwith
consultation
M3. _

Number of clients/patients/consumerstreatedfor co-occurring disorder in collaborative
manner

ld4. -Number
of clients/patients/consumers
treatedfor co-occurringdisorderin integrated
manner
N._
Number of clients/patients/consumerswho were not treated at your program becausethey had cooccurringdisorders.

POLICIES ON SCREENING, ASSESSMENT, REFERRAL AND TREATMENT

1. SCREENING AND ASSESSMENT
all clients to be

A. Does
scree

fl Yes (answeritem AI and skip item B)
n No @kipitem Al and answer item B)
have a written policy/procedurerequiring assessment
Al. Does your progr arn/facllitylorganization
of all clienis whose screeningsuggeststhe existenceof a co-occurringdisorder?[YES SOP.I
tr
n

Yes (skiPitem B and answer item C)
No (skzPitem B and answer item C)

all clients to be
B. Does your progr amlfacrlitybrganization have a written policy/procedure requiring
INTAKE'I
FOR
SEEN
ur."rrl,l foi the presenceof a co-occurringdisorder?YES,IF

n Yes
tr

No

C. (Answerthis questionregardlessof the answersto questionsA, AI, and B)
program?
Which statementbest deJcribesthe typicat way assessmentsare conductedby your
"i'
"b"
to your program,
apply
o"ly if all minimum elementsof the definition of assessment
or
[Check
"a-"1
otherwiseanswer
a.
b.

n
tr

c. fl

We do not conductassessments
Assessmentsare conductedby a member of our program staff (include personscontracted
assessclients/patients)[THIS ONE.I
We refer out for assessments

2. TREATMENT AI\D REFERRAL
A. Does your program/facrlity/orgarization have a written policy/procedure governing disposition of
personswho have a co-occurring disorder? [THE CHARTERI
I Yes
fl No (skip to item C)
B. Which option bestdescribeshow your program tlpically operates?
a. E
b. n
c. E
d. Ll
e. n

We do not tlpically servepersonsknown to have co-occurring disorders
We treat mental disordersonly
We treatsubstanceabusedisordersonly
We treatboth mentaldisordersand substanceabusedisorderswithin oLlrprogram
We treatmental disorderswithin our program and refer the personfor substanceabuse

treatment
f. fl
We treat substanceabusedisorderswithin cur program and refer the person for mental
disorder treatment
C. What type of servicesare personswith co-occurring conditions most likely to receive from your
pro gram/faci lityi organi zation?

a.
b.
c.
d.
e.

n
tr
I
tr
I

No contact
Minimal Coordination
Consultation
Collaboration
lntegration