Agreement among three mental health screening assessments conducted at intake

Offenders’ immediate mental health needs are assessed at intake to the Correctional Service of Canada (CSC) by the Computerized Mental Health Intake Screening System (CoMHISS), Version 2 and two health assessments - Form 1244 sections I and II. Although each assessment screens in some unique offenders for follow-up for mental health issues, the CoMHISS was found to be the most sensitive of the three, screening in the largest number of unique offenders.

The table displays agreement among the assessments. Agreement across all three tools was 61%. In 56% of cases, the three assessments agreed that no follow-up was necessary, but only 5% of the sample were flagged for follow-up by all three assessments.

The CoMHISS appears to be the most sensitive of the three tools since 32% of offenders were flagged based on the CoMHISS, while 21% were flagged based on the 1244 section I and 18% were flagged based on the 1244 section II. Furthermore, the CoMHISS identified 13% of offenders that the other two tools did not, and the 1244 sections I and II each uniquely identified 5% of offenders.

Several tools are used to screen offenders for potential mental health issues at various points in their incarceration. It is currently unknown, however, if these tools screen in the same or different offenders. The CSC requires more information on the tools to ensure an effective and efficient screening process.

Referral Outcomes across CoMHISS and 1244 Sections I and II (N = 390)

Reception units were provided with a list of offenders who had recently been admitted to their institution and who had completed CoMHISS, Version 2. CoMHISS data were obtained from electronic databases. Reception units were asked to provide data from the offenders’ health status admission assessments, known as Form 1244 sections I and II. There were 390 offenders with complete data on all three assessments (CoMHISS, Version 2, 1244 section I, and 1244 section II). For each offender, we examined whether each assessment tool resulted in a referral for mental health follow-up (i.e., whether offenders were “screened in” for further evaulation).

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Prepared by: Geoff Wilton, Jenelle Power, & Lynn Stewart