Offenders with mental health problems and substance misuse: cluster analysis based on the Addiction Severity Index version 6 (ASI-6)

Abstract

There is an urgent need to improve assessment and treatment among offenders with mental health problems and substance misuse (the “triply troubled”). An examination of the usefulness of the recently published Addiction Severity Index version 6 (ASI-6; Cacciola, J.S., Alterman, A.I., Habing, B., & McLellan, A.T. (2011). Recent status scores for version 6 of the Addiction Severity Index (ASI-6). Addiction, 106, 1588–1602) in classifying offenders with mental health problems and substance misuse was undertaken. A total of 207 offenders with suspect mental disorder and substance misuse about to go through a forensic psychiatric evaluation in Sweden were interviewed with the ASI-6. Data were cluster analyzed. Four distinct clusters emerged: (1) “less troubled” (n = 35), (2) “severely triply troubled” (n = 30), (3) “triply troubled with medical problems (n = 52) and (4) “working triply troubled” (n = 87). The ASI-6 proved useful in the classification of offenders with mental health problems and substance misuse. The authors suggest that the ASI-6 be used in research on the classification of the triply troubled.

Keywords:

• ASI-6
• co-existing problems
• comorbidity
• dual diagnosis
• substance use
• mental health
• assessment

Acknowledgements

We thank the National Board of Forensic Medicine for providing the data necessary for our analyses. We also thank Eva Bjerke and Mats Wikström for data collection and coding.