1Implementation of SBIRT for Individuals with Substance Use Disorder in InpatientPsychiatric UnitDepartment of Nursing
2Need for Substance Use Disorder Screening in Inpatient Psychiatric UnitIntroductionSubstance-related illnesses are rising among those with severe mental illness, with ratesranging between 40-75 percent (Cushman et al., 2016). Dual diagnosis is a considerabletreatment issue not just because drug abuse creates a new set of problems when it comes toestablishing therapy programs but also because it has a significant impact on mental symptomssuch as delusions, hallucinations, and sadness. Dually diagnosed individuals' disruptive,disinhibited, and non-compliant behavior impacts mental illness treatment. The frequency oftreatment-resistant patients and significant recurrence rates are evidence of comorbidity.Substance abuse is declared a public health problem globally.The impact of problematic use ofillicit substances cannot be underestimated as most countries battle economically to eliminatethis crisis. While many substances are readily available for users, alcohol has been identified as acommonly abused substance (Cushman et al., 2016).A reliable diagnosis of drug use disorders and the availability of resources are used toplan suitable treatment for dually diagnosed individuals (Wamsley et al., 2018). However, thereis a significant disparity between scientific and clinical estimates of the problem. Even thoughnumerous studies, including our own, have shown a high prevalence of substance use disordersamong psychiatric patients, the frequency of these disorders has been dramatically reduced inhospital emergency rooms, and they are not diagnosed even when reliable evidence exists inclinical records. In one study, the adoption of a diagnostic interview schedule identified 30percent more individuals as having substance-related disorders than documented in medicalrecords. In another study, emergency care practitioners discovered a 5% prevalence rate of
3substance use disorders in a sample of people with a mental health condition. In contrast, aresearch team found a 71 percent rate in the same group.Screening programs for dual diagnosis aim to promote more complete assessments andincrease access to treatment options for people with serious mental illnesses. In this population,diagnostic accuracy necessitates reliable and accurate methods for identifying drug use problems.However, because many structured measures have only been validated with drug use disorders,there are issues with screening for dual diagnosis. With minimal systematic effort—that is, few"head-to-head" comparisons—the measures have only lately been employed to assess substancemisuse and dependence among people with mental illness. The research looked into this andfound that substance use screening measures may accurately detect substance-related diseases inpsychiatric patients.