Principles and practice for the screening, diagnosis, and assessment of persons with co-occurring mental illness and substance abuse

Abstract

The incidence of dual diagnosis in individuals who have severe mental illnesses has been demonstrated to be very high, and among individuals identified with substance abuse, the lifetime rate of co-occurring psychiatric disorders are as high as eighty percent. Effective treatment of individuals with dual problems depends on accurate screening, diagnosis, and comprehensive assessment. A series of principles of evaluation are presented and described in this article. The principles are pragmatic and simple guides to good MISA assessment practices, and include a review of assessment instruments that can be effectively used by front line clinicians. Critical elements of evaluation are presented that significantly impact on those principles.