From the Guidelines
Behavioral health screening is indicated with laboratory tests such as the Alcohol, Smoking and Substance Involvement Screening Test, Alcohol Use Disorders Identification Test, and Drug Abuse Screening Test.
Screening Techniques
These evidence-based screening techniques are used to identify patients with low-risk patterns of alcohol use and no drug use, who receive screening only, while those with moderate- to high-risk alcohol use patterns or illicit drug use receive brief interventions, and patients who fulfill defined criteria for addictive patterns of behavior are referred to specialty care 1.
- The Alcohol, Smoking and Substance Involvement Screening Test is used to screen for substance use disorders.
- The Alcohol Use Disorders Identification Test is used to screen for alcohol use disorders.
- The Drug Abuse Screening Test is used to screen for drug use disorders.
Brief Interventions
Brief interventions generally follow a scripted program, which varies by site, and include motivational enhancement therapy and brief behavioral therapy approaches 1.
Cost Offset
Addressing behavioral health issues has been shown to decrease overall health care costs, with a 1999 meta-analysis finding that medical use decreased an average of 15.7% for patients receiving behavioral health treatment, whereas medical use increased by more than 12% for related control participants 1.
From the Research
Laboratory Tests for Behavioral Health Screening
The following laboratory tests and screening tools are indicated for behavioral health screening:
- Pediatric Symptom Checklist-17 (PSC-17) for screening pediatric behavioral health concerns including anxiety, depression, and conduct problems 2
- Patient Health Questionnaire-9 (PHQ-9) for screening depression and other behavioral health conditions in primary care settings 2, 3
- Screen for Child Anxiety Related Emotional Disorders (SCARED) for screening anxiety in pediatric populations 2
- Screening tools for mood, anxiety, alcohol use, drug use, sleep, intimate partner violence, and chronic pain in emergency department settings 4
- Tools stemming from the Patient Health Questionnaire for screening behavioral health conditions in primary care settings 3
- The Behavioral Health Laboratory (BHL) for telephone-based systematic clinical assessment of mental health and substance abuse symptoms in primary care clinics 5
- Developmental and behavioral screening tools such as PEDS, ASQ, PSC, and Brigance screens for early detection of developmental and behavioral problems in primary care settings 6
Screening Tools and Their Applications
The screening tools mentioned above have various applications in different settings, including:
- Primary care facilities for routine screening of behavioral health problems 2, 3, 5, 6
- Emergency department settings for expanded behavioral health screening 4
- Pediatric practices for screening pediatric behavioral health concerns 2
- Integrated healthcare delivery systems for screening adult patients for common mental and substance use disorders 4, 3