Developing and Validating a Brief Jail Mental Health Screen in Maryland and New York, 2005-2006 (ICPSR 21184)

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Study Purpose View help for Study Purpose

Jails need a reliable screening tool to identify inmates that require further mental health assessment and treatment. The goal of this research project was to develop an efficient mental health screen that would aid in the early identification of severe mental illnesses and other acute psychiatric problems during the intake process. The researchers sought to validate the Brief Jail Mental Health Screen (BJMHS) as such a tool. Specifically, this research sought to add four additional items to the eight item screen targeting depression and trauma to improve the performance of the screen with women.

Study Design View help for Study Design

For this project, the Brief Jail Mental Health Screen (BJMHS) was revised by reanalyzing the data from a previous study, conducting an extensive review of existing mental health screens, and considering feedback from professionals in the mental health field. The resulting revised Brief Jail Mental Health Screen (BJMHS-R) included the original eight yes/no items on the BJMHS and four additional yes/no questions that were added to try to improve the accuracy of the BJMHS: three pertaining to depression and one relating to post-traumatic stress.

Participants in the study included male and female jail detainees admitted to one of four county jails, two in Maryland (Montgomery County, MD, and Prince George County, MD) and two in New York (Rennselaer County, NY, and Monroe County, NY), from November 2005 to June 2006. A total of 10,562 jail detainees were screened using the BJMHS-R (Part 1), which generally occured within 24 hours after their initial booking. The screening data were used to identify a sub-sample of detainees who were systematically sampled for a detailed clinical assessment, the Structured Clinical Interview for DSM-IV (SCID), which was conducted by a trained research interviewer in order to validate the screen. The SCID is a semi-structured interview designed to assess the presence of selected DSM-IV Axis I diagnoses. Detainees were considered to be referred for further evaluation if they endorsed at least two of the ten symptoms or either of the two medical history questions of the BJMHS-R. This sub-sample was constructed so that there would be an adequate sample of inmates from each jail who scored positive on the BJMHS-R, and was designed to comprise a large number of females to enable separate analysis by gender.

As soon as detainees were classified into the referral and non-referral groups, a Subject Tracking Program, programmed in MS Access, was used to identify and generate a list of potential detainee participants for the SCID interview. This list of potential participants was given to jail administration staff who verified each detainee's presence in the jail and who helped schedule consultation visits between the detainees and the study's trained Clinical Research Interviewers. The Clinical Research Interviewers, who were blind to the detainees' sampling group statuses, approached the detainees on their list of potential participants and completed SCID interviews with those who consented to participate in the study. A subset of 464 jail detainees completed the SCID interviews (Part 2), which were conducted within 72 hours of a detainee's admission to the jail. Participation in this study was voluntary. Informed consent forms were required and obtained for all Structured Clinical Interview for DMM-IV (SCID) interview participants. Participants were informed that their decision to participate would not affect their stay in the jail and were administered a brief quiz to assess their competency to consent.

Sample View help for Sample

Part 1: Participants included 10,562 male and female jail detainees admitted to one of four county jails, two in Maryland (Montgomery County, MD, and Prince George County, MD) and two in New York (Rennselaer County, NY, and Monroe County, NY) from November 2005 to June 2006. Part 2: The screening data were used to identify a sub-sample of 945 detainees who were systematically selected within sampling subgroups for a detailed clinical assessment conducted by a trained research interviewer using the Structured Clinical Interview for DSM-IV (SCID). This sample was constructed so that there would be an adequate sample from each jail scored positively on the BJMHS-R (Referrals) and designed to comprise a large enough number of females to enable separate analysis by gender resulting in an over-sampling in those two groups. Participants in the final SCID sub-sample were 464 detainees that included 175 Referrals (68 males and 107 females) and 289 Non-referrals (138 males and 151 females).

Universe View help for Universe

All male and female jail detainees admitted to one of four county jails in Maryland (Montgomery County, MD, and Prince George County, MD) and in New York (Rennselaer County, NY, and Monroe County, NY) from November 2005 to June 2006.

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Mode of Data Collection View help for Mode of Data Collection

Description of Variables View help for Description of Variables

Part 1, Tracking Data, contains 54 variables, including items and scores from the revised Brief Jail Mental Health Screen (BJMHS-R), that were used to used to identify and generate a list of potential detainee participants for the Structured Clinical Interview for DSM-IV (SCID) interview. Variables in Part 1, Tracking Data, include jail code, screen administration date and time, gender, age, admission status, race, 12 BJMHS-R variables, officer's comments, officer's sex, selection for SCID interview, SCID consent, SCID interview outcome, referral status, and computed variables.

Part 2, Interview Data, contains 326 variables, including items and scores from both the BJMHS-R and the SCID interviews, that were used to validate the screen. Variables in Part 2, Interview Data, include jail code, age and sex of respondent, admission status, race, 12 BJMHS-R variables, officer's comments, officer's sex, and referral status. Additional items in Part 2 from the SCID interview include bipolar variables, major depressive variables, dysthymic disorder variables, mood disorder variables, substance abuse variables, schizophrenia disorder variables, delusional disorder variables, psychotic disorder variables, anxiety disorder variables, principle Axis I diagnosis, interview diagnosis variables, treatment, comments, other delusion variables, hallucination variables, symptom variables, traumatic event variables, computed variables, post-traumatic stress variables, serious mental illness, and time taken to complete the SCID interview.

Response Rates View help for Response Rates

Part 1: Not applicable. Part 2: The overall response rate was 68.6 percent. Approximately 26 percent of those selected for a detailed clinical assessment using the Structured Clinical Interview for DSM-IV (SCID) were released prior to the interview or were unavailable for a variety of reasons (illness, etc.). The refusal rate, while high, was identical to the 31 percent refusal rate in prior research and was most likely due to the lack of compensation and difficulty scheduling within the jail constraints.

Presence of Common Scales View help for Presence of Common Scales

Scales used were the a revised version of the Brief Jail Mental Health Screen (BJMHS-R) and the Structured Clinical Interview for DSM-IV (SCID).

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Original Release Date View help for Original Release Date

2008-09-08

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none

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