Agreement among Three Mental Health Screening Assessments

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What it means

Offenders' immediate mental health needs are assessed at intake to the Correctional Service of Canada (CSC) though Sections I and II of the Health Assessment Form 1244 and the Computerized Mental Health Intake Screening System Version 2 (CoMHISS). Each tool identifies some unique offenders for follow-up for mental health services, with the CoMHISS identifying the largest number of unique offenders. However, results of CoMHISS are not available as quickly as either section of Form 1244. Form 1244 may offer the efficiency to screen for immediate needs of mental health services due to acute illnesses or potential suicide or self-injury risk while CoMHISS' inclusiveness may identify offenders with other mental health problems, as well as those who do not have these problems. In choosing the most appropriate screening tools, many factors need to be considered, including accuracy, resource requirements, and timeliness of information.

What we found

Agreement across all three screening tools was 61%. In 56% of cases, the results of the three assessment tools agreed that no follow-up was necessary, but only 5% of the sample was flagged for follow-up by all three assessments (see table). The CoMHISS is the most inclusive of the three tools, identifying approximately 32% of offenders, while 21% were identified based on the results of Form 1244 Section I and 18% based on Form 1244 Section II. Furthermore, the CoMHISS identified 13% of offenders that the other two tools did not, while the Forms 1244 Sections I and II each identified 5% of offenders not identified by the other two tools. The pattern of referrals based on the tools did not differ significantly for Aboriginal offenders.

Why we did this study

Several tools are used to screen offenders for potential mental health issues at intake to CSC. It is currently unknown, however, if these tools identify the same or different offenders. CSC requires more information on the tools to ensure an effective and efficient screening process.

What we did

Reception units were provided with a list of offenders who had recently been admitted who had completed CoMHISS Version 2. Reception units were asked to provide data from the offenders' health status admission assessments, known as Form 1244 Sections I and II. There were 390 offenders with complete data on all three assessments (CoMHISS, Version 2, 1244 Section I, and 1244 Section II). For each offender, we examined whether each assessment tool resulted in a referral for mental health follow-up.

Referral Outcomes across CoMHISS and Form 1244 Sections I and II (N = 390)
1244 Section I
1244 Section II

Yes = identified. No = not identified.

No No No 56
Yes No No 13
Yes Yes No 8
Yes No Yes 5
Yes Yes Yes 5
No Yes No 5
No No Yes 5
No Yes Yes 3

For more information

Wilton, G., Stewart, L., & Power, J. (2015). Agreement among three mental health screening measures (Research Brief B-58). Ottawa, ON: Correctional Service of Canada.

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