--- title: Mental Health Screening and Evaluation description: "\tMental Health Screening and Evaluation – Evidence-based practice\r\n\r\n\r\nSummary of the Evidence\r\n\r\n•\tMental health screening and evaluation is a process to (1) determine if a client experiences mental illness (screening) and (2) identify the mental illness and determine how it may be affecting the client (evaluation).\r\n•\tMental health screening and evaluation is an evidence-based practice that can help officers select the best strategies to work with clients who experience mental illness.\r\n•\tSupervision staff and people involved in the criminal justice system are generally favorable toward mental health screening and evaluation.\r\n\r\n\r\nWhat Is Mental Health Screening and Evaluation\r\n•\tBecause mental illness can affect a client’s quality of life and may serve as a barrier to their achieving certain prosocial goals (e.g., employment), it is important to conduct mental health screenings and evaluations with clients who need them.\r\no\tScreening is the process for determining if a client has symptoms associated with mental illness. The outcome is typically yes or no.\r\n\tScreening is often done with a short form that an officer completes with a client.\r\n\tScreening should be completed with all clients at intake, or if they start to show signs of mental illness or high stress.\r\no\tEvaluation is the process of defining the nature of the problem, determining the diagnosis, and developing specific treatment recommendations for addressing the problem or diagnosis (SAMHSA, 2019).\r\n\tEvaluation should be completed if a mental health screener indicates the presence of a mental illness.\r\n•\tThere are many cases where clients who screen positive for mental illness may not need/want intervention to address that illness. Officers should always be ready to provide resources/referrals to assist clients with mental illness, but mandatory treatment is often unnecessary.\r\n\r\nHow Is Mental Health Screening and Evaluation Used?\r\n•\tIt is recommended that an evidence-based screener be used (see Appendix A1 for a list of free, online tools).\r\n•\tAn evidence-based screener should include the following elements:\r\no\ttype of mental health symptoms the client is experiencing (e.g., anxiety, depression, hallucinations [auditory or visual], mood swings)\r\no\tfrequency with which the client experiences these symptoms\r\no\tlast time the client experienced these symptoms\r\no\tnegative impact (social, legal, employment, family) these symptoms may have had on the client’s life\r\n•\tRisk-need assessment tools are not substitutes for a dedicated mental health screening tool.\r\n\r\nHow Can It Be Used to Monitor Compliance?\r\n•\tScreening and evaluation should never be done with the purposes of monitoring the client.\r\n\r\nHow Can It Be Used as a Supervision Tool?\r\n•\tIf a client begins to have a small-to-moderate amount of compliance issues, screening and evaluation can be an appropriate response to noncompliance to determine the role mental illness is playing.\r\n•\tWhen the screener/evaluation has identified a mental illness and when client behavior is connected to the mental illness, psychological interventions (e.g., CBT, DBT, individual or group therapy) are an appropriate response for medium- and high-risk clients with a lot of compliance problems. Such interventions should only be used as a last resort and in cases where the client’s noncompliance is clearly and directly connected to mental illness (e.g., an individual with schizophrenia who is unwilling to apply for a job due to paranoid thought patterns).\r\no\tIn all cases, the officer should encourage the client to seek treatment voluntarily first.\r\n\r\nWhat Are the Costs of Mental Health Screening and Evaluation?\r\n•\tThere are many validated mental health screening and evaluation tools available free online (see Appendix A1). In most cases, the cost is equal to the officer’s time taken to administer the tool.\r\n\r\nWhat Do Supervision Staff Think About Mental Health Screening and Evaluation?\r\n•\tSupervision staff report that mental health screening and evaluation are\r\no\tsometimes appropriate for all low-risk clients and\r\no\talways appropriate for all medium- and high-risk clients.\r\n\r\nWhat Should You Expect When Using Mental Health Screening and Evaluation?\r\nClient Outcomes\r\n•\tMental illness can manifest as one of several conditions which may affect a client’s quality of life. Such conditions include anxiety, depression, bipolar disorder, and schizophrenia.\r\n•\tWhile mental illness can affect a client’s quality of life, evidence indicates that it is not directly linked to criminal behavior.\r\no\tIn some cases, in the presence of certain social conditions, mental illness can contribute to criminal behavior.\r\n\tThis can occur when people with mental illness are denied access to employment, housing, transportation, etc. In some cases, this may occur due to discrimination.\r\n\tCo-occurring issues like substance use disorder can also make it more likely that a person with mental illness will commit a crime.\r\n•\tMental illness can also severely impact a client’s quality of life, contributing to both personal and professional problems.\r\no\tIn some cases, these problems can result from the mental illness directly. In other cases, they can result from society’s response to people with mental illness.\r\n•\tIf mental illness is not found to be contributing to dangerous behavior, officers should go no further than to provide resources (and, if requested, assistance) for the client to seek treatment.\r\no\tIt is important to remember that not everyone with mental illness wishes to be “cured.” \r\no\tIn some cases, the medications used to suppress the symptoms of mental illness are accompanied by unpleasant side effects. For some people experiencing mental illness, these side effects may be more unpleasant and undesirable than the symptoms of the mental illness itself.\r\n•\tIn cases where mental illness severely impacts a client’s quality of life, screening and evaluation can benefit the client by identifying the potential presence of mental illness and revealing how it might be connected to negative life outcomes in ways previously unknown by both officer and client.\r\n\r\nIs Mental Health Screening and Evaluation an Evidence-Based Practice?\r\n•\tYes, there is a large body of research supporting the effective use of mental health screening and evaluation with clients inside and outside of the criminal legal system (the “criminal justice” or “legal” system is referred to as the criminal legal system in this document).\r\n\r\nWhat Do People Formerly Involved in the Criminal Legal System Think About Mental Health Screening and Evaluation?\r\n•\tPeople who have been involved in the criminal legal system report that mental health screening and evaluation is\r\no\tsometimes appropriate for all low-risk clients and\r\no\tsometimes appropriate for all medium- and high-risk clients, except for those who have committed intimate partner violence, for whom it is always appropriate.\r\n\r\nCommunication That Strengthens the Officer-Client Relationship (Messaging)\r\n•\tDiscuss with the client why the screening and evaluation is occurring and ensure they understand how the information can be used to benefit them. \r\n•\tInform the client that the screening is a standard procedure done with all clients on supervision. \r\n•\tClients may disagree with the results of the screening/evaluation. When this occurs, clients are more open to officers who present themselves as helpers and who use their experience on the job to push back on clients’ ideas.\r\n•\tTell clients how noncompliance with treatment will be treated. \r\n•\tClient and officer should agree on what the client should do in the case they feel treatment is not working for them. \r\n•\tDiscuss with the client any concerns they might have surrounding mental illness. Potential topics can include stigma, side effects of medication, and time/resources necessary to seek treatment.\r\n\r\nSpecial Considerations When Using Mental Health Screening and Evaluation with Subpopulations\r\n\r\nGang-Involved\tSame as the general population\r\nGeneral Violence\tScreening and evaluation are important to determine if violent behavior is affected by mental illness.\r\nIntimate Partner Violence\tPeople who have committed intimate partner violence are at higher risk for experiencing personality disorders (Holtzworth-Munroe et al., 2000), a history of trauma (Rhodes et al., 2009), and/or conduct disorder (Ehrensaft et al., 2004). These are or can be associated with mental illnesses.\r\nSerious Mental Illness\tMental health screening and evaluation are essential to determine if a client experiences serious mental illness(es). Many people on supervision with mental illness have had poor experiences with treatment providers in the past, and they may be mistrustful of them and hesitant to engage in treatment.\r\nSubstance Use Disorder\tPeople with substance use disorder often experience mental illness, making mental health screening and evaluation especially important for this population." url: "https://www.gmuace.org/appropriateness-statement-package/treatments/mental-health-screening-and-evaluation/" updated: "2023-06-09" category: Treatments tags: - Assessments - Behavioral Health - "Evidence-Based Practices" - Treatments --- # Mental Health Screening and Evaluation ***Mental Health Screening and Evaluation – Evidence-based practice*** Summary of the Evidence - Mental health screening and evaluation is a process to (1) determine if a client experiences mental illness (screening) and (2) identify the mental illness and determine how it may be affecting the client (evaluation). - Mental health screening and evaluation is an evidence-based practice that can help officers select the best strategies to work with clients who experience mental illness. - Supervision staff and people involved in the criminal justice system are generally favorable toward mental health screening and evaluation.   What Is Mental Health Screening and Evaluation How Is Mental Health Screening and Evaluation Used? What Do Supervision Staff Think About Mental Health Screening and Evaluation? What Should You Expect When Using Mental Health Screening and Evaluation? Special Considerations When Using Mental Health Screening and Evaluation with Subpopulations   **Appendix A1: Screening and Assessment Tools** The following is a list of evidence-based screening tools. All tools are free, accessible online or by emailing the creator, and contain less than 50 items. | Name | Mental Health | | | Sensitive to Change | Screening | Diagnosis | Tx Monitoring & Evaluation | | --- | --- | --- | --- | --- | --- | --- | --- | | Name | Mental Health | Where to Obtain | Number of Items | Sensitive to Change | Screening | Diagnosis | Tx Monitoring & Evaluation | | The Clinically Useful Anxiety Outcome Scale (CUXOS) | Anxiety | [http://www.outcometracker.org](http://www.outcometracker.org) | 2Q | Yes | Yes | | Yes | | Generalized Anxiety Disorder Screener (GAD-7) | Anxiety | [http://www.phqscreeners.com](http://www.phqscreeners.com) | 7 | Yes | Yes | Yes | Yes | | Hamilton Rating Scale for Anxiety (HAM-A) | Anxiety | [http://www.outcometracker.org](http://www.outcometracker.org) | 15 | Yes | Yes | | Yes | | Liebowitz Social Anxiety Scale Clinician-Report (LSAS-CR) | Anxiety | [http://healthnet.umassmed.edu/mhealth/LiebowitzSocialAnxiet yScale.pdf](http://healthnet.umassmed.edu/mhealth/LiebowitzSocialAnxiet%20yScale.pdf) | 24 | Yes | Yes | | Yes | | Liebowitz Social Anxiety Scale Self-Report (LSAS-SR) | Anxiety | [http://asp.cumc.columbia.edu/S AD/](http://asp.cumc.columbia.edu/S%20AD/) | | | | | | | Panic Disorder Severity Scale (PDSS) | Anxiety | [http://www.outcometracker.org](http://www.outcometracker.org) | 7 | Yes | Yes | Yes | Yes | | Fear Questionnaire (FQ) | Anxiety | [http://www.outcometracker.org](http://www.outcometracker.org) | 24 | Yes | | | Yes | | Penn State Worry Questionnaire (PSWQ) | Anxiety | [http://www. outcometracker.org](http://www.%20outcometracker.org) | 16 | Yes | Yes | | Yes | | Social Phobia Inventory (SPIN) | Anxiety | [http://www.psychtoolkit.com](http://www.psychtoolkit.com) | 17 | Yes | Yes | | Yes | | Worry and Anxiety Questionnaire (WAQ) | Anxiety | [http://www.psychology.concor dia.ca/fac/dugas/downloads/en/ WAQ.pdf](http://www.psychology.concor%20dia.ca/fac/dugas/downloads/en/%20WAQ.pdf) | 11 | Yes | Yes | Yes | Yes | | The Clinically Useful Depression Outcome Scale (CUDOS) | Depression | [http://www.outcometracker.org](http://www.outcometracker.org) | 18 | Yes | Yes | Yes | Yes | | Hamilton Rating Scale for Depression (HAM-D) | Depression | [http://www.outcometracker.org](http://www.outcometracker.org) | 17 | | Yes | | | | The Inventory of Depressive Symptoms and the Quick Inventory of Depressive Symptoms (IDS and QIDS) | Depression | [http://www.ids-qids.org](http://www.ids-qids.org) | 30 16 | Yes | Yes | Yes | Yes | | Patient Health Questionnaire-9 (PHQ-9) | Depression | [http://www.phqscreeners.com/](http://www.phqscreeners.com/) | 9 | Yes | Yes | Yes | Yes | | Eating Disorder Diagnostic Scale (EDDS) | Eating Disorders | [http://homepage.psy.utexas.edu/homepage/group/sticelab/scales/#edds](http://homepage.psy.utexas.edu/homepage/group/sticelab/scales/#edds) | 22 | Yes | Yes | Yes | Yes | | Sick, Control, One, Fat, Food Screening Tool (SCOFF) | Eating Disorders | [http://www.marquette.edu/coun seling/documents/AQuickAssessmentforEatingConcerns.pdf](http://www.marquette.edu/coun%20seling/documents/AQuickAssessmentforEatingConcerns.pdf) | 5 | | Yes | | | | Altman Self-Rating Mania Scale (ASRM) | Mania | [http://www.cqaimh.org/pdf/tool asrm.pdf](http://www.cqaimh.org/pdf/tool%20asrm.pdf) | 5 | Yes | Yes | | Yes | | Bech-Rafaelsen Mania Scale (MAS) | Mania | [http://opapc.com/images/pdfs/ MRS.pdf](http://opapc.com/images/pdfs/%20MRS.pdf) | 11 | Yes | Yes | | Yes | | Young Mania Rating Scale (YMRS) | Mania | [http://dcf.psychiatry.ufl.edu/files/2011/05/Young-Mania-Rating-Scale-Measure-with-background.pdf](http://dcf.psychiatry.ufl.edu/files/2011/05/Young-Mania-Rating-Scale-Measure-with-background.pdf) | 11 | Yes | Yes | | Yes | | National Institutes of Health Patient Reported Outcomes Measurement Information System (PROMIS) | Overall Mental Health | [https://www.assessmentcenter.net/promisforms.aspx](https://www.assessmentcenter.net/promisforms.aspx) | 4-30 | | Yes | | | | Patient Health Questionnaires (PHQ) | Overall Mental Health | [http://www.phqscreeners.com/](http://www.phqscreeners.com/) | 11 | Yes | Yes | Yes | Yes | | Recovery Assessment Scale (RAS) | Overall Mental Health | [http://www.power2u.org/downloads/pn-55.pdf](http://www.power2u.org/downloads/pn-55.pdf) | 41 | Yes | | | Yes | | Borderline Evaluation of Severity over Time (BEST) | Personality Disorders | [http://psychiatry.ucsd.edu/bord erlineServices.html](http://psychiatry.ucsd.edu/bord%20erlineServices.html) | 15 | Yes | Yes | Yes | Yes | | Columbia-Suicide Severity Rating Scale (C- SSRS) | Suicidality | [http://www.cssrs.columbia.edu](http://www.cssrs.columbia.edu) | 20 | Yes | Yes | NA* | Yes | | The Suicide Behaviors Questionnaire - Revised (SBQ-R) | Suicidality | [http://www.integration.samhsa. gov/images/res/SBQ.pdf](http://www.integration.samhsa.%20gov/images/res/SBQ.pdf) | 4 | | Yes | NA* | | | Impact of Event Scale-Revised (IES-R) | Trauma | [ude.fscu@ssiew.leinad](http://ude.fscu@ssiew.leinad) | 22 | | Yes | | | | Los Angeles Symptom Checklist (LASC) | Trauma | [ude.enidreppep@yofd](http://ude.enidreppep@yofd) | 43 | | Yes | Yes | | | The Post-Traumatic Stress Disorder Checklist - Civilian Version (PCL-C) | Trauma | [http://www.ptsd.va.gov](http://www.ptsd.va.gov) | 17 | | Yes | Yes | | | The Trauma History Screen (THS) | Trauma | [http://www.istss.org/AssessmentResources/5347.htm](http://www.istss.org/AssessmentResources/5347.htm) | 14 | | Yes | | | | The Trauma History Questionnaire (THQ) | Trauma | [http://ctc.georgetown.edu/toolkit/](http://ctc.georgetown.edu/toolkit/) | 24 | | Yes | | |   Note. * = not a diagnosable disorder; cannot be a diagnostic tool. Table adapted from: Beidas, R. S., Stewart, R. E., Walsh, L., Lucas, S., Downey, M. M., Jackson, K., Fernandez, T., & Mandell, D. S. (2015). Free, brief, and validated: Standardized instruments for low-resource mental health settings. *Cognitive and Behavioral Practice*, *22*(1), 5-19. https://doi.org/10.1016/j.cbpra.2014.02.002     **Similar Topics** ## [Treatment Implementation Considerations](https://www.gmuace.org/appropriateness-statement-package/treatments/treatment-implementation-considerations/) ## [Prosocial Modeling](https://www.gmuace.org/appropriateness-statement-package/motivation-techniques/prosocial-modeling/) ## [Incentives](https://www.gmuace.org/appropriateness-statement-package/motivation-techniques/incentives/)