What is the difference between screening and assessment?

Mental health screenings are simple, brief, and generally administered by non-clinical staff. Screening requires minimal training, and decisions to refer youth for further evaluation are usually based on agency policy, rather than on the recommendation of a trained clinician. Screening can be an efficient part of identifying mental health problems for a variety of purposes.

In contrast to screening, mental health assessment is a comprehensive evaluation usually intended to identify service needs. Comprehensive assessment may identify concerns not picked up by screening. Assessment of service needs should include a diagnosis to guide referral for appropriate services. A comprehensive assessment for this purpose should incorporate information from as many available sources as possible. For example, the major Axis I psychiatric disorders, suicidality, and the youth’s functioning and impairment at home and in school are all important to measure. Assessment should be multifaceted and consist of direct observation, face-to-face interview, mental status examination, chart review, interview with parents/other adults, and family history.

Why conduct psychiatric screenings and assessments on youth in juvenile justice settings?

Youth within the juvenile justice system are at high risk for psychiatric conditions, and these conditions may have contributed to the risk of offending, or may interfere with rehabilitation. Hoge (1999) indicates that considerable discretion is afforded to personnel in the justice system. That is, they tend to rely heavily on informal and unsystematic assessment and decision-making procedures. As a result, invalid inferences about youths mental health conditions are frequently made. Our recent work indicates that justice youth report high levels of Depression and Anxiety disorders, beyond expected high rates of Conduct Disorder and Substance Abuse. As Hoge (1999) points out, use of reliable and comprehensive psychiatric assessments greatly enhances case finding and decision-making regarding programming, thereby increasing equality. This information is also important for diverting youth inappropriately placed in justice programs, and monitoring ongoing mental health during participation in justice system programs.