Severe mental illness and addictions: assessment considerations

Area of Science:

• Psychiatry
• Psychology
• Public Health

Background:

• Substance use disorders (SUDs) frequently co-occur with severe mental illness (SMI).
• Accurate assessment of SUDs in SMI populations is challenging but essential for effective care.
• Existing literature offers guidance but requires synthesis for practical application.

Purpose of the Study:

• To provide a selective overview of empirical literature on substance use assessment in persons with SMI.
• To organize the review around key questions for screening, diagnosis, treatment planning, and outcome evaluation.
• To identify promising future research directions for substance use assessment in SMI.

Main Methods:

• Literature review focusing on empirical studies.
• Organization of findings around three primary assessment goals: screening, diagnosis, and treatment planning/outcome evaluation.
• Identification of methodological concerns and best practices.

Main Results:

• Discussion of appropriate screening tools for psychiatric settings and associated methodological issues.
• Analysis of challenges in diagnosing comorbid SUDs and strategies to improve diagnostic reliability and validity.
• Consideration of suitable outcome measures and the role of assessment in treatment planning.

Conclusions:

• Effective substance use assessment requires tailored approaches for individuals with SMI.
• Further research is needed to validate existing measures, understand self-report accuracy, and enhance instrument relevance.
• Improved assessment practices can lead to better treatment planning and outcomes for this vulnerable population.