Screening and Assessment of Co-Occurring Disorders in the Justice ...

•y•y•y•y•y•yMental health history and current psychological functioning`` Mental health information should include current and past symptoms(e.g., suicidality, depression, anxiety, psychosis, paranoia, stress, selfimage,inattentiveness, impulsivity, hyperactivity), treatment history,and patterns of denial and manipulationHistory of interaction between the co-occurring disorders`` It is particularly important to examine the chronological history of thetwo disorders, including periods before the onset of drug and alcoholuse, and during periods of abstinence (including enforced abstinencewhile in jail or prison). In some settings, substance use and mentalhealth history information is collected separately. This tends to hinderan understanding of the effects of drugs and alcohol on mental healthsymptoms and the extent to which mental disorders exist independentlyfrom substance abuse. Unfortunately, few assessment instrumentsexamine the chronological relationship between co-occurring disordersand the intertwined nature of these disordersMedical/health care history and status`` Key areas to examine include history of injury and trauma, chronicdisease, physical disabilities, substance toxicity and withdrawal,impaired cognition, neurological symptoms, and prior use of psychiatricmedication. If a history of Attention-Deficit/Hyperactivity Disorder(AD/HD) is suspected, assessment should examine attention andconcentration difficulties, hyperactivity and impulsivity, and thedevelopmental history of childhood AD/HD symptomsCriminal justice history and status`` The complete criminal history should be reviewed, in addition to currentcriminal justice statusCultural and linguistic needs`` Cultural beliefs about mental and substance use disorders, treatmentservices, and the role of treatment professionals`` Abilities to adapt to the treatment culture and to deal with conflict inthese settings`` Reading and writing skills`` Barriers to providing cultural and linguistic servicesIndividual strengths and environmental supports`` Ability to manage mental and substance use disorders`` Social supports (e.g., peers, family)`` Interests and skills`` Expectancies related to treatment`` Motivation for change, and salient incentives and goals for the individual35