Severe mental illness and addictions: assessment considerations.

This article provides a selective overview of the empirical literature on substance use assessment for persons with severe mental illness. We organize the review around key questions related to three assessment goals. With regard to screening, we address what screening tools are appropriate for use in psychiatric settings, and what methodological concerns arise regarding their use in these contexts. With regard to diagnosis, we discuss why diagnosing comorbid disorders is difficult and how clinicians can enhance the reliability and validity of their diagnoses. With regard to the related goals of treatment planning and outcome evaluation, we consider what are appropriate outcome measures, and how assessment information can assist in treatment planning. Finally, we outline three promising directions for future research: (a) evaluating the psychometric properties of established substance-related measures in persons with severe mental illness, (b) identifying the conditions under which self-report information is more or less accurate, and (c) improving the population relevance of substance assessment instruments.