Development of the PsyCheck screening tool: an instrument for detecting common mental health conditions among substance use treatment clients

Abstract

Background: Mental health problems, particularly anxiety and mood disorders, are common among clients of alcohol and other drug treatment services, and symptom management is increasingly within the purview of alcohol and drug workers. A mental health screening toolkit, PsyCheck, was created for use by non-mental health specialists to detect common mental health problems, to screen for suicide risk, and to explore mental health treatment history among drug treatment clients.

Aims: This study was undertaken to (a) choose a brief mental health screen to incorporate into PsyCheck and (b) identify cut-off scores suitable for clinical use.

Method: One hundred and seventeen individuals in treatment for an alcohol or drug problem completed the Self-Reporting Questionnaire (SRQ), the General Health Questionnaire (GHQ-28), and the mental health module of the Composite International Diagnostic Interview–Auto (CIDI-A). ROC curve analysis was used to identify optimum cut-off scores for identifying clients who are likely to have a mental health disorder.

Results: The SRQ had good validity and was superior to the frequently used GHQ-28, and was therefore chosen for inclusion in PsyCheck. A cut-off score of over 4 gave the best balance of sensitivity (0.809) and specificity (0.837). In addition, two mental health treatment questions were highly correlated with a current mental health disorder.

Conclusions: The SRQ component of PsyCheck is a valid instrument for detecting mental health problems among a range of drug treatment clients.

Keywords:

• comorbidity
• mental health
• PsyCheck
• screening
• substance use treatment

Acknowledgements

The authors wish to thank Anthony Nutting and Kim Marr for their assistance on this project and Professor John B. Saunders for his support. This project was partly funded by the Alcohol, Tobacco and other Drug Service (ATODS), Queensland Health. Permission to modify the SRQ and incorporate it into PsyCheck was kindly granted to the authors by the World Health Organisation.