Identifying Need for Mental Health Services in Substance Abuse Clients

Objective: Counselor detection of co-occurring disorders is critical to ensuring that clients with mental disorders entering substance abuse treatment receive appropriate care. This study sought to (a) examine correspondence between client-reported psychiatric symptoms and client and counselor ratings of need for mental health treatment and (b) explore client- and program-level characteristics associated with client and counselor underrating. Methods: Psychiatric symptoms and client and counselor ratings of need for mental health services were collected using the Addiction Severity Index (ASI) among 3,972 clients entering outpatient substance abuse treatment at 30 treatment programs across the U.S. Kappa statistics were used to determine level of agreement between client-reported symptoms and client and counselor ratings of need for mental health treatment. Multilevel modeling was used to examine characteristics associated with underrating. Results: While agreement between symptoms and ratings of need for...