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Fact sheets and summary tables

From: Concurrent Substance Use and Mental Health Problems in Youth: Screening for Concurrent Substance Use and Mental Health Problems in Youth (© 2009, CAMH)
 

This section begins with two tables that list the 20 tools that emerged from the rating and review process (see p. 67 for a description of the process).

The tables are followed by fact sheets for each of the tools. The fact sheets include a brief description of the tools and information about:

  • appropriate target populations
  • administration options
  • accessibility and cost
  • how to obtain copies of the tools
  • test development data.

Summary tables

These tables maintain the important distinction between tools that can be used to identify: 

  • mental disorders but not substance use disorders
  • substance use disorders but not other mental disorders
  • both mental and substance use disorders (i.e. dual-function).

Selecting a tool from within these broad categories will depend on factors such as the mandate of the service, and its current screening and assessment processes. There may be several advantages for a community network of mental health and substance use services to choose a "dual-function" tool so as to facilitate communication and coordination between services.

Age group

The tables are also organized by the age group for which the various tools have been validated, using the broad categories of "preschool to age 11" (Table 1) and pre-teens and teens aged "12 to 17" (Table 2). Note, however, this grouping was approximate as we also include the precise age range recommended for each tool, and that several tools span these two broad categories. We believe, however, that it is helpful to make some separation by target age in order to facilitate decisions on the adoption of a given tool in particular services or sectors.

Screening stage

Another key element of the summary charts is the breakdown provided for what we refer to as "Stage 1" or "Stage 2" screening tools. Essentially this separates tools that are designed to cast a wide net for "any" disorder or for broad clusters of disorders (e.g., internalizing and externalizing) from those tools that seek a much finer, but still tentative, identification of specific disorders or problem areas. Within the dual-function tools this distinction is captured nicely by the GAIN-Short Screener (GAIN-SS) and the DISC Predictive Scales (DPS). Both are screening tools but they differ in length, purpose and, therefore, coverage. Assessing the potential value of the tools in Tables 1 and 2 should therefore also be guided by the three-stage model advanced earlier for screening and assessment generally.

Input from end users

In the far right side of Tables 1 and 2 we summarize "stakeholder enthusiasm"; summary ratings developed based on feedback from a group of CD champions brought together to support the knowledge exchange process with respect to these screening tools. Following a webinar with the group that reviewed progress to date on the project and sought their input, participants were asked for more detailed feedback on the various tools. To date, feedback has been received from seven respondents, two of whom are from the same program. Five of the respondents work in substance abuse services, and two within a program for people with either mental health or substance use problems. Questions included what they liked most and least about each tool and how it may or may not work within their own program or the sector in which they work. They were also asked to indicate how important it was for a tool to identify both mental health and substance use problems and to rate the importance of various criteria in selecting a screening tool for their program. Virtually all agreed that it was "very important" for the same screening tool to identify both mental health and substance use problems. Participants were also asked to keep in mind the distinction between Stage 1 and Stage 2 screeners. Feedback from the CD champions also showed that the most important criteria for them in choosing a tool were (in order of importance):

  • overall quality of the reliability and validity data,
  • ease of scoring and interpretation
  • brevity/administration time
  • self-completion
  • cost.

Given the scope of our review process and the many different types of input, it is challenging to summarize everything into a "best bet" category. Rather we recommend the use of this report, the summary tables, and the more detailed technical report as facilitating local, regional and provincial decision-making on the optimal tool or tools for different contexts. That said, there are three points that have come through loud and clear, and confirmed stakeholder feedback obtained to date. First, there is considerable value in considering various tools in the context of a staged approach to screening and assessment (i.e., Stage 1 and Stage 2 screeners followed by comprehensive assessment as dictated by the results). Secondly, there is a high value on selecting tools that screen for both mental AND substance use disorders. Thirdly, end-users want tools that come with strong reliability and validity data, and secondarily emphasize the practical issues such as ease of administration, scoring and brevity. Cost is an important consideration as well but does not dominate among various selection criteria. 

 

Table 1: Summary of Screening Tools for Children Approximately
Preschool to Age 11

Screening Tool

Screening Stage

Quality of Reporting

Strength of Reliability and Validity

Stakeholder Enthusiasm

Mental Health but not SUD

Pediatric Symptom Checklist (PSC). Age 4-16

1st

2nd

High

Med

Low

High

Med

Low

High

Med

Low

Youth Outcome Questionnaire (Y-OQ-12). Age 4-17

1st

2nd

High

Med

Low

High

Med

Low

High

Med

Low

Child Behavior Checklist (CBCL). Age 6-18

1st

2nd

High

Med

Low

High

Med

Low

High

Med

Low

Strengths and Difficulties Questionnaire (SDQ). Age 6-8

1st

2nd

High

Med

Low

High

Med

Low

High

Med

Low

Reporting Questionnaire for Children (RQC). Age 5-15

1st

2nd

High

Med

Low

High

Med

Low

High

Med

Low

Child Symptom Inventory-4 (CSI-4). Age 5-12 

1st

2nd

High

Med

Low

High

Med

Low

Limited feedback

Early Childhood Inventory-4 (ECI-4). Preschool

1st

2nd

High

Med

Low

High

Med

Low

Limited feedback

Substance Use Disorder but no other MH                    

No SUD only tools for this young age group 

 

 

 

 

 

 

 

 

 

 

 

Both SUD and other MH

DISC Predictive Scales (DPS). Age 9-17

1st

2nd

High

Med

Low

High

Med

Low

High

Med

Low

GAIN Short Screener (GSS). Age 10-17

1st

2nd

High

Med

Low

High

Med

Low

High

Med

Low

 

 

Table 2: Summary of Screening Tools for Pre-Teens and Adolescents Approximately Age 12–17

Screening Tool

Screening Stage

Quality of Reporting

Strength of Reliability and Validity

Stakeholder Enthusiasm

Mental Health but not SUD

Pediatric Symptom Checklist (PSC). Age 4–16 

1st 

2nd 

High 

Med 

Low 

High 

Med

Low 

High 

Med 

Low

Youth Outcome Questionnaire (Y-OQ-12). Age 4–17 

1st 

2nd 

High 

Med 

Low  

High 

Med

Low 

High  

Med 

Low 

Child Behavior Checklist (CBCL). Age 6–18 

1st 

2nd 

High 

Med 

Low  

High 

Med

Low 

High  

Med 

Low 

Strengths and Difficulties Questionnaire (SDQ). Age 11–16  

1st 

2nd 

High 

Med 

Low  

High 

Med 

Low 

High  

Med 

Low

Youth Self-Report (YSR). Age 11–18 

1st 

2nd 

High 

Med 

Low

High 

Med 

Low 

High  

Med 

Low

Reporting Questionnaire for Children (RQC). Age 5–15 

1st 

2nd 

High 

Med 

Low 

High 

Med 

Low 

Limited feedback

General Health Questionnaire (GHQ). Age 11–15 

1st 

2nd 

High 

Med 

Low 

High 

Med 

Low 

Limited feedback

Substance Use Disorder but no other MH

CRAFFT. Age 14–18 

1st 

2nd 

High 

Med 

Low 

High 

Med 

Low 

High 

Med

Low

RAFFT. Age 13–18 

1st 

2nd 

High 

Med 

Low 

High 

Med 

Low 

High 

Med

Low

Drug Acknowledgement Scale (ACK). Age 14–18 

1st 

2nd 

High 

Med 

Low 

High

Med 

Low 

Limited feedback

Alcohol/Drug Problem Proneness Scale (PRO). Age 14–18  

1st 

2nd 

High 

Med 

Low 

High 

Med 

Low 

Limited feedback

MacAndrew Alcoholism Scale-Revised (MAC-R). Age14–18 

1st 

2nd 

High 

Med 

Low 

High 

Med 

Low 

Limited feedback

DEP-ADO. Age 14–19  

1st 

2nd 

High 

Med 

Low 

High 

Med 

Low 

High 

Med

Low

Rutgers Alcohol Problem Index (RAPI). Adolescents 

1st 

2nd 

High 

Med 

Low 

High 

Med 

Low 

High 

Med

Low

Both SUD and other MH

Problem Oriented Screening Instrument for Teenagers (POSIT). 12–19 

1st 

2nd 

High 

Med 

Low 

High 

Med 

Low 

High 

Med

Low

DISC Predictive Scales (DPS). Age 9–17 

1st 

2nd 

High 

Med 

Low 

High 

Med 

Low 

High

Med 

Low

GAIN Short Screener (GSS). Age 10–17 

1st 

2nd 

High 

Med 

Low 

High 

Med 

Low 

High

Med 

Low

Drug Use Screening Inventory (DUSI) and (DUSI-R). 12+  

1st 

2nd 

High 

Med 

Low 

High 

Med 

Low 

High

Med 

Low