Screening for comorbid substance use disorders among people with a mental health diagnosis who present to emergency departments

Background The current study was designed to evaluate a screening process for alcohol and other drug (AOD) problems with clients presenting with mental health (MH) issues at an emergency department (ED) at an urban hospital. Method In total, 145 ED clients were referred for MH issues. Of these, 53 were screened for AOD problems using an initial screen of two questions. Those identified as being at-risk on the initial screen were given a more detailed AOD screen. Fifty-three percent were found to be over the risk threshold indicating substance abuse or dependence problems. The response of nine clinicians and managers to the screening process was also evaluated. Results The results demonstrate the clinical utility of a two item, followed by a further eight item screen to detect AOD problems. There was also a high level of acceptance among managers of this screening process. Discussion The implication of these findings for the management of clients with MH problems and comorbid AOD problems are discussed