Screening for behavioral health disorders should be a priority throughout points of contact within a community, including by pediatricians, teachers, and emergency room practitioners. Early identification of mental health issues and trauma can help individuals more effectively manage their mental health issues and create appropriate treatment plans.
More specific screening and assessment are also critical once an individual has contact with the justice system in order to ensure the system’s treatment and supervision responses are tailored to the individual’s criminogenic risks and needs. All individuals coming into jail should be screened for mental health and substance use disorders using an evidence-based tool validated for the population that is screened. Then, if indicated by the screening instrument, an appropriate assessment should follow..
Learn More About Screening for Substance Abuse Disorders
Substance use disorders are associated with worse criminal justice outcomes and therefore require special and dynamic treatment strategies. Once in custody, valid and reliable screening tools should be used to identify substance use disorders to provide detention partners with an informed picture of treatment and custody needs. These tools are typically less than a dozen items, can be administered by non-clinicians, and are often in the public domain and free. Many screening tools also now implicitly recognize the reality that mental health needs co-occur with substance use disorders. An excellent treatise on why and how to effectively use screening and assessment in a justice context is SAMHSA'S Screening and Assessment of Co-Occurring Disorders in the Justice System.
Examples of brief SUD screens include;
- TCU (Texas Christian University) Drug Screen V
- DAST-10 (Drug Abuse Screening Tool)
- SSI-SA (Simple Screening Instrument for Substance Abuse)
Learn More About Screening for Mental Health Disorders
Using valid and reliable mental health screening instruments both out of custody and at jail intake can identify new treatment needs (or initial treatment needs) pending pre-trial release. Screening and assessment information can also be provided directly to the court to facilitate more appropriate and tailored pre-trial orders, referral to an appropriate treatment court, and in-court responses to individuals. Common mental health screens include:
The two most prevalent correctional or jail-specific mental health screens are:
- Brief Jail Mental Health Screen
- Correctional Mental Health Screen (CMHS) Note: There is a version for men and one for women.
- The relative attributes of these two screens are discussed extensively in a National Institute of Justice publication Mental Health Screens for Corrections
Screening for trauma is important both to identify appropriate treatment interventions and to avoid re-traumatizing the person. Widely validated and used tools include:
Other resources:
- Stepping Up Initiative, Implementing Mental Health Screening and Assessment
- Center for Court Innovation, Digest of Evidence-based Assessment Tools
- National Center for State Courts, Miami-Dade County Adult Drug Court: Trauma Study Report
Learn More About Pretrial Risk Assessments
Pretrial release decisions are particularly impactful on arrestees with behavioral health needs. Incarceration, even for a short period of time can have disproportionately negative consequences for this population. Pretrial release without incarceration also represents an important opportunity for connecting people with behavioral health needs to services.
Pretrial risk assessments can inform these pretrial release decisions. Numerous assessment tools exist. One validated and publicly available assessment is the Public Safety Assessment tool, released by the Laura and John Arnold Foundation in 2017. The Public Safety Assessment tool uses nine factors to assess the risk of a defendant to fail to appear as required or to commit a new offense before trial.
- Laura and John Arnold Foundation (now Arnold Ventures), Public Safety Assessment: Risk Factors and Formula
- Advancing Pretrial Policy and Research, About the Public Safety Assessment
Learn More About Criminogenic Risk and Needs Screening and Assessment Tools
Risk and needs screening and assessment at all stages of the criminal justice process is a universally accepted evidence-based practice. Screens and assessments can be accomplished using a variety of tools, but all of these tools should be validated for the target population and for predictive soundness before use. This process should occur at jail booking, as a prerequisite for court treatment program placement, upon commencement of criminal justice related behavioral health treatment, prior to sentencing, and an ongoing basis to assess treatment progress in reducing criminogenic risk. Common risk and risk/need screens and assessment instruments include:
- The Level of Service Inventory–Revised (LSI-R)
- Ohio Risk Assessment System (ORAS)
- Practitioner's Guide to COMPAS Core
- Risk and Needs Triage (RANT®)
Resources related to evaluating and selecting risk/need instruments:
- Substance Abuse and Mental Health Services Administration, Screening and Assessment of Co-Occurring Disorders in the Justice System
- National Drug Court Institute, Selecting and Using Risk and Need Assessments
- Sarah Desmarais & Jay P. Singh, Risk Assessment Instruments Validated and Implemented in Correctional Settings in the United States: An Empirical Guide
- Council of State Governments Justice Center, A Ten-Step Guide to Transforming Probation Departments to Reduce Recidivism
The effectiveness of behavioral health interventions also depends on identifying other factors that may need to be assessed and addressed, such as suicide risk and trauma history. The evidence based tools that should be used to screen and assess these factors are discussed in the SAMHSA screening and assessment document listed above.