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International Journal of Mental Health and Addiction

Erschienen in:

01.01.2008

Mental Health Screening in Addiction, Corrections and Social Service Settings: Validating the MMS

verfasst von: Mary Jane Alexander, Gary Haugland, Shang P. Lin, David N. Bertollo, Francis A. McCorry

Erschienen in: International Journal of Mental Health and Addiction | Ausgabe 1/2008

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Abstract

Objective

This paper tests the validity of a simple and easy to use scale, the Modified Mini Screen (MMS) to identify people with mental health problems in the treatment ecology for chemical dependency, including specialty sector substance abuse treatment settings, and shelters, jails and street community outreach programs.

Methods

Four hundred and seventy-six individuals in chemical dependency treatment and in jails, shelters and outreach settings completed a set of 22 items to screen for mental disorders—the MMS—and a validation interview—the Structured Clinical Interview for Diagnosis (SCID). ROC curve analysis was used to (1) determine the optimal range of cut points for identifying mental health problems in this culturally heterogeneous sample and wide range of treatment and community settings, and (2) calculate overall accuracy, sensitivity, specificity, and positive and negative predictive values for the MMS.

Results

Forty three percent of the sample met criteria for a DSM-IV diagnosis of anxiety, mood or psychotic disorder. At cut points of 6–9, the sensitivity of the MMS ranged from 0.63–0.82, its specificity ranged from 0.61–0.83, and its overall accuracy ranged from 70–75%. At these cut points, the MMS screen performed equally well for men and women, and for African Americans and Caucasians, and is comparable to the performance of other screens validated for less compromised populations. A decision tool has been developed based on these results that is available from the authors.

Conclusion

The MMS performs well in naturalistic chemical dependency treatment settings, jails, shelters and street outreach programs across gender and ethnic groups, and can provide a useful tool in service systems developing a “No Wrong Door” policy for persons with co-occurring mental health and substance abuse problems.

A computer assisted version of the 22 item MMS, though not validated in this study, is available from the authors. Contact dbertollo@nki.rfmh.org.

Alexander, M. J., & Haugland, G. (2000). Integrating services for co-occurring disorders: Final report prepared for the New York State Conference of Local Mental Hygiene Directors. Orangeburg, NY: Nathan S. Kline Institute for Psychiatric Research.

American Psychiatric Association (2000). DSM-IV-TR: Diagnostic and Statistical Manual of Mental Disorders-IV-TR (4 ed., rev). Washington, DC: American Psychiatric Association.

Aneshensel, C. S., Frericks, R. R., Clark, C. A., & Yokopenic, P. A. (1982). Measuring depression in the community: A comparison of telephone and personal interviews. Public Opinion Quarterly, 46, 110–121.PubMedCrossRef

Brandau, S. (2005). Strategies to integrate services for co-occurring disorders: Network building and screening. Presentation #3: Pilot Adoption Study and the role of the single state agency in promoting evidence based practices. 15th Conference on State Mental Health Agency Services Research, Program Evaluation and Policy, February 6–8, 2005: Baltimore MD. Retrieved December 1, 2005 from http://www.nriinc.org/Conference/Conf05/Presentations/Sun1430_FH_Brandau.pdf.

Bureau of Justice Statistics (2006). Special report: Mental health problems of prison and jail inmates. US Department of Justice, Office of Justice Programs, September (#NCJ 213600).

Burnam, M. A., & Watkins, K. E. (2006). Substance abuse with mental disorders: Specialized public systems and integrated care. Health Affairs, 25(3), 648–658.PubMedCrossRef

Caton, C. L. M., Dominguez, B., Schanzer, B., Hasin, D. S., Shrout, P. E., Felix, A., et al. (2005). Risk factors for long-term homelessness: Findings from a longitudinal study of first-time homeless single adults. American Journal of Public Health, 95(10), 1753–1759.PubMedCrossRef

Caton, C. L. M., Shrout, P. E., Eagle, P. F., Opler, L. A., Felix, A., & Dominguez, B. (1994). Risk factors for homelessness among schizophrenic men: A case-control study. American Journal of Public Health, 84, 265–270.PubMed

Center for Substance Abuse Treatment (2005). Substance Abuse Treatment for Persons with Co-Occurring Disorders. Treatment Improvement Protocol (TIP) Series 42. DHHS Publication No. (SMA) 05-3992. Substance Abuse and Mental Health Services Administration: Rockville, MD.

Cichetti, D. (1994). Guidelines, criteria, and rules of thumb for evaluating normed and standardized assessment instruments in psychology. Psychological Assessment, 6, 284–290.CrossRef

Commission on Chronic Illness (1957). Chronic illness in the United States: Vol. 1. Prevention of chronic illness. Harvard University Press, Cambridge MA, p. 45 (as cited in: World Health Organization. Principles and Practices of Screening for Disease. Geneva: WHO; 1968).

Compton, W. M., Cottler, L. B., Jacobs, J. L., Ben Abdallah, A., & Spitznagel, E. L. (2003) Role of psychiatric disorders in predicting drug dependence treatment outcomes. American Journal of Psychiatry, 160, 890–895.PubMedCrossRef

Culhane, D. P., Avery, J. M., & Hadley, T. R. (1997). The rate of public shelter admission among Medicaid-reimbursed users of behavioral health services. Psychiatric Services, 48(3), 390–392.PubMed

Culhane, D. P., Avery, J., & Hadley, T. R. (1998). The prevalence of treated behavioral disorders among adult shelter users. American Journal of Orthopsychiatry, 26, 207–232.

Culhane, D. P., & Metraux, S. M. (1999). One-year rates of public shelter utilization in NYC (1990, 1995) and Philadelphia (1995). Population Research and Policy Review, 18, 219–236.CrossRef

Derogatis, L. R. (1993). BSI, Brief Symptom Inventory: Administration, scoring & procedures manual. Minneapolis, MN: National Computer Systems.

Dickey, B., & Azeni, H. (1996). Persons with dual diagnoses of substance abuse and major mental illness: Their excess costs of psychiatric care. American Journal of Public Health, 86, 973–977.PubMed

Dickey, B., Normand, S. L., Weiss, R. D., Drake, R. E., & Azeni, H. (2002). Medical morbidity, mental illness, and substance use disorders. Psychiatric Services, 53, 861–867.PubMedCrossRef

Draine, J., Salzer, M. S., Culhane, D. P., & Hadley, T. R. (2002). Role of social disadvantage in crime, joblessness, and homelessness among persons with serious mental illness. Psychiatric Services, 53, 565–573.PubMedCrossRef

Drake, R. E., & Wallach, M. A. (2000). Dual diagnosis: 15 year of progress. Psychiatric Services, 51(9), 1126–1129.PubMedCrossRef

Epstein, J., Barker, P., Vorburger, M., & Murtha, C. (2004). Serious mental illness and its co-occurrence with substance abuse disorders, 2002. Substance Abuse and Mental Health Services Administration Office of Applied Studies, Rockville, MD. Retrieved from http://oas.samhsa.gov/CoD/CoD.pdf..

Felker, B., Yazel, J. J., & Short, D. (1996). Mortality and medical comorbidity among psychiatric patients: A review. Psychiatric Services, 47, 1356–1363.PubMed

Grella, C. E., & Hser, Y. I. (1997). A county survey of mental health services in drug treatment programs. Psychiatric Services, 48, 950–952.PubMed

Grella, C. E., & Stein, J. A. (2006). Impact of program services on treatment outcomes of patients with co morbid mental and substance use disorders. Psychiatric Services, 57, 1007–1015.PubMedCrossRef

Hasin, D., Samet, S., Nenes, E., Meydan, J., Matseoane, K., & Waxman, R. (2006). Diagnosis of comorbid psychiatric disorders in substance users assessed with the Psychiatric Research Interview for Substance and Mental Disorders for DSM-IV. American Journal of Psychiatry, 163, 689–696.PubMedCrossRef

Haugland, G., Siegel, C., Alexander, M. J., & Galanter, M. (1991). Psychiatric patients with chemical abuse: A survey of hospitals in New York State treating psychiatric patients with chemical abuse disorders. Hospital and Community Psychiatry, 42(12), 1215–1220.PubMed

Health Canada (2001). Best practices: Concurrent mental health and substance use disorders. Ottawa: Health Canada.

Hiday, V. A., Swartz, M. S., Swanson, J. W., Borum, R., & Wagner, H. R. (1999). Criminal victimization of persons with severe mental illness. Psychiatric Services, 50, 62–68.PubMed

Institute of Medicine, Committee on Crossing the Quality Chasm (2006). Improving the quality of health care for mental and substance-use conditions. Washington, DC: National Academy Press.

Kessler, R. C., Barker, P. R., Colpe, L. J., Epstein, J. F., Gfroerer, J. C., Hiripi, E., et al. (2003). Screening for serious mental illness in the general population. Archives of General Psychiatry, 60, 184–189.PubMedCrossRef

Kessler, R. C., Chiu, W. T., Demler, O., & Walters, E. E. (2005). Prevalence, severity, and comorbidity of 12-month DSM-IV disorders in the National Comorbidity Survey Replication. Archives of General Psychiatry, 62, 617–627.PubMedCrossRef

Kessler, R. C., McGonagle, K. A., Zhao, S., Nelson, C. B., Hughes, M., Eshleman, S., et al. (1994). Lifetime and 12-month prevalence of DSM-III-R psychiatric disorders in the United States. Results from the National Comorbidity Survey. Archives of General Psychiatry, 51, 8–19.PubMed

Kessler, R. C., Nelson, C. B., McGonagle, K. A., Edlund, M. J., Frank, R. G., & Leaf, P. J. (1996). The epidemiology of co-occurring addictive and mental disorders: Implications for prevention and service utilization. American Journal of Orthopsychiatry, 66, 17–31.PubMedCrossRef

Klinkman, M. S. (1997). Competing demands in psychosocial care. A model for the identification and treatment of depressive disorders in primary care. General Hospital Psychiatry, 19(2), 98–111.PubMedCrossRef

Lecrubier, Y., Sheehan, D., Weiller, E., Amorim, P., Bonora, I., Sheehan, K., et al. (1999). The Mini International Neuropsychiatric Interview (M.I.N.I.), a short diagnostic structured interview: Reliability and validity according to the CIDI. European Psychiatry, 12, 224–231.CrossRef

Lehman, A. F. (1996). Heterogeneity of person and place: Assessing co-occurring addictive and mental disorders. American Journal of Orthopsychiatry, 66(1), 32–41.PubMedCrossRef

Lehman, A. F., Myers, C. P., Dixon, L. B., & Johnson, J. L. (1994). Defining subgroups of dual diagnosis patients for service planning. Hospital and Community Psychiatry, 45(6), 556–561.PubMed

McClish, D. K. (1989). Analyzing a portion of the ROC Curve. Medical Decision Making, 9(3), 190–195.PubMedCrossRef

McFarland, B. H., & Gabriel, R. M. (2004). Service availability for persons with co-occurring conditions. Psychiatric Services, 55, 978.PubMedCrossRef

McLellan, A. T., Luborsky, L., Woody, G. E., & O’Brien, C. P. (1980). An improved diagnostic evaluation instrument for substance abuse patients: The Addiction Severity Index. Journal of Nervous and Mental Disease, 168(1), 26–33.PubMedCrossRef

Metz, C. E. (1978). Basic principles of ROC analysis. Seminars in Nuclear Medicine, 8(4), 283–298.PubMedCrossRef

Michaud, C. M., Murray, C. J. L., & Bloom, B. R. (2001). Burden of disease: Implications for future research. Journal of the American Medical Association, 285, 535–539.PubMedCrossRef

Minkoff, K. (2001). Developing standards of care for individuals with co-occurring psychiatric and substance use disorders. Psychiatric Services, 52, 597–599.PubMedCrossRef

Moos, R. H., Finney, J. W., Federman, E. B., & Suchinsky, R. (2000). Specialty mental health care improves patients’ outcomes: Findings from a nationwide program to monitor the quality of care for patients with substance use disorders. Journal of Studies on Alcohol, 61, 704–713.PubMed

Mossman, D., & Somoza, E. (1991). ROC curves, test accuracy, and the description of diagnostic tests. Journal of Neuropsychiatry and Clinical Neuroscience, 3, 330–333.

Murray, C. J. L., & Lopez, A. D. (1996). The global burden of disease and injury series, volume 1: A comprehensive assessment of mortality and disability from diseases, injuries, and risk factors in 1990 and projected to 2020. Harvard School of Public Health on behalf of the World Health Organization and World Bank. Cambridge, MA: Harvard University Press.

National Association of State Mental Health Program Directors/National Association of State Alcohol and Drug Abuse Directors (NASMHPD/NASADAD) (1998). National dialogue on co-occuring mental health and substance use disorders. http://www.nasadad.org/index.php?base_id=100 (accessed June 1, 2007).

Osher, F. (1996). A vision for the future: Toward a service system responsive to those with co-occurring addictive and mental disorders. American Journal of Orthopsychiatry, 66, 71–76.PubMedCrossRef

Ouimette, P. C., Moos, R. H., & Finney, J. W. (2000). Two-year mental health service use and course of remission in patients with substance use and posttraumatic stress disorders. Journal of Studies on Alcohol, 61, 247–253.PubMed

Pepper, B., Kirshner, M. C., & Ryglewicz, H. (1981). The young adult chronic patient: Overview of a population. Hospital and Community Psychiatry, 32(7), 463–469.PubMed

RachBeisel, J., Scott, J., & Dixon, L. (1999). Co-occurring severe mental illness and substance use disorders: A review of recent research. Psychiatric Services, 50, 1427–1434.PubMed

Ray, G. Y., Weisner, C. M., & Mertens, J. R. (2005). Relationships between use of psychiatric services and five-year alcohol and drug treatment outcomes. Psychiatric Services, 56, 164–171.PubMedCrossRef

Ridgely, S. M., Goldman, H. H., & Willenbring, M. (1990). Barriers to the care of persons with dual diagnosis: Organizational and financing issues. Schizophrenia Bulletin, 16(1), 123–132.PubMed

Ritsher, J. B., Moos, R. H., & Finney, J. W. (2002). Relationship of treatment orientation and continuing care to remission among substance abuse patients. Psychiatric Services, 53, 595–601.PubMedCrossRef

Rohde, P., Lewinsohn, P. M., & Seeley, J. R. (1997). Comparability of telephone and face-to-face interviews in assessing Axis I and II disorders. American Journal of Psychiatry, 154, 1593–1598.PubMed

Rosenberg, S. D., Drake, R. E., Wolford, G. L., Mueser, K. T., Oxman, T. E., Vidaver, R.M., et al. (1998). Dartmouth Assessment of Lifestyle Instrument (DALI): A substance use disorder screen for people with severe mental illness. American Journal of Psychiatry, 155(2), 232–238.PubMed

Rounsaville, B. J., Dolinsky, Z. S., Babor, T. F., & Meyer, R. E. (1987). Psychopathology as a predictor of treatment outcome in alcoholics. Archives of General Psychiatry, 44, 505–513.PubMed

Rounsaville, B. J., Kosten, T. R., Weissman, M. M., & Kleber, H. D. (1986). Prognostic significance of psychopathology in treated opiate addicts: A 2.5-year follow up study. Archives of General Psychiatry, 43, 739–745.PubMed

Sheehan, D. V., Lecrubier, Y., Sheehan, K. H., Amorim, P., Janavs, J., Weiller, E., et al. (1998). The Mini International Neuropsychiatric Interview (M.I.N.I.): The development and validation of a structured diagnostic psychiatric interview for DSM-IV and ICD-10. Journal of Clinical Psychiatry, 59(20), 22–33.PubMed

Shrout, P. E. (2002). Reliability. In M.T. Tsuang & M. Tohen (Eds.) Textbook of Psychiatric Epidemiology, 2nd ed (pp 131–148). New York, NY: Wiley-Liss.CrossRef

Sobin, P., Weissman, M. M., Goldstein, R. B., & Adams, P. (1993). Diagnostic interviewing for family studies: Comparing telephone and face-to-face methods for the diagnosis of lifetime psychiatric disorders. Psychiatric Genetics, 3, 227–233.CrossRef

Spitzer, R. L., Kroenke, K., Williams, J. B. W., & the Patient Health Questionnaire Primary Care Study Group (1999). Validation and utility of a self-report version of PRIME-MD, the PHQ Primary Care Study. Journal of the American Medical Association, 282, 1737–1744.PubMedCrossRef

Spitzer, R. L., Williams, J. B. W., Gibbon, M., & First, M. B. (1988). Structured clinical interview for DSM-III-R-Patient version. New York, NY: New York State Psychiatric Institute, Biometrics Research Department.

Steadman, H. J., Scott, J. E., Osher, F., Agnese, T. K., & Robbins, P. C. (2005). Validation of the brief jail mental health screen. Psychiatric Services, 56, 816–822.PubMedCrossRef

Substance Abuse and Mental Health Services Administration (2002). Report to congress on the prevention and treatment of co-occurring substance abuse disorders and mental disorders. Rockville, MD: US Department of Health and Human Services, Substance Abuse and Mental Health Services Administration.

Substance Abuse and Mental Health Services Administration (2005). Results from the 2004 National Survey on Drug Use and Health: National findings. (NSDUH Series H-28, DHHS Publication No. SMA 05-4062). Rockville, MD: Office of Applied Studies.

Substance Abuse and Mental Health Services Administration (2006). Results from the 2005 National Survey on Drug Use and Health: National findings. (NSDUH Series H-30, DHHS Publication No. SMA 06-4194). Office of Applied Studies: Rockville, MD.

Wang, P. S., Lane, M., Olfson, M., Pincus, H. A., Wells, K. B., & Kessler, R. C. (2005). Twelve-month use of mental health services in the United States: Results from the National Comorbidity Survey Replication. Archives of General Psychiatry, 62, 629–640.PubMedCrossRef

Ware, J., Kosinski, M., & Keller, S. D. (1996). A 12-item short-form health Survey: Construction of scales and preliminary tests of reliability and validity. Medical Care, 34(3), 220–233.PubMedCrossRef

Weeks, M. F., Kulka, R. A., Lessler, J. T., & Whitmore, R. W. (1983). Personal versus telephone surveys for collecting household health data at the local level. American Journal of Public Health, 73(12), 1389–1394.PubMedCrossRef

Weisner, C., Matzger, H., & Kaskutas, L. A. (2003). How important is treatment? One-year outcomes of treated and untreated alcoholic dependent individuals. Addiction, 98, 901–911.PubMedCrossRef

Weissman, M., Broadhead, E., Olfson, M., Sheehan, D. V., Hoven, C., Conolly, P., et al. (1998). A diagnostic aid for detecting (DSM-IV) mental disorders in primary care. General Hospital Psychiatry, 20, 1–11.PubMedCrossRef

Zimmerman, M., & Chelminski, I. (2006). A scale to screen for DSM-IV Axis I disorders in psychiatric outpatients: Performance of the Psychiatric Diagnostic Screening Questionnaire. Psychological Medicine, 36(11), 1601–1611.PubMedCrossRef

Zweig, M. H., & Campbell, G. (1993). Receiver-operating characteristic (ROC) plots: a fundamental evaluation tool in clinical medicine . Clinical Chemistry, 39, 561–577 (published erratum appears in Clinical Chemistry Aug 1993, 39(8), 1589).PubMed

Titel: Mental Health Screening in Addiction, Corrections and Social Service Settings: Validating the MMS
verfasst von: Mary Jane Alexander
Gary Haugland
Shang P. Lin
David N. Bertollo
Francis A. McCorry
Publikationsdatum: 01.01.2008
Verlag: Springer-Verlag
Erschienen in: International Journal of Mental Health and Addiction / Ausgabe 1/2008
Print ISSN: 1557-1874
Elektronische ISSN: 1557-1882
DOI: https://doi.org/10.1007/s11469-007-9100-x

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