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Dissertation

Evaluating the screening, assessment, and documentation of substance abuse problems in a college health center

17 April 2001

Abstract

This program evaluation examined the screening, assessment and documentation of student substance abuse patterns by healthcare providers in a college health and counseling center. A high-risk subset of the population, consisting of those students placed on medical leave or denied registration, was studied. Baseline data examining assessment practices was gathered by reviewing fifty-seven charts in the pre-intervention phase. Files were reviewed to determine whether students were assessed for drug and alcohol use, and how rapidly after entering the system the assessment took place. Data were gathered regarding presenting problem patterns and co-occurring psychiatric disorders correlated with substance abuse, according to the literature. Regardless of the presence of indicators suggesting the utility of assessment, students were evaluated only about 25% of the time for potential drug and alcohol problems. The most commonly occurring psychiatric diagnoses were mood and anxiety disorders. Though drugs and alcohol were implicated in roughly 50% ofthe medical leaves and denials, students were unlikely to present with problems specifically related to drugs or alcohol. Rather, 82% of presenting symptoms were exclusively represented as about other problems. Problems, reported with the most frequency were sexually related problems, sleep disturbance, upper-respiratory, and minor injuries, co-morbid psychiatric diagnoses, depression, stress, and appetite or weight changes. The second phase of the study, the intervention phase, included educating staff regarding the initial findings regarding typical presenting problems and co-morbid diagnoses discovered in the pre-intervention phase of the chart review. A Lifestyles Questionnaire (LSQ) was introduced to facilitate discussion of substance use patterns between staff and students. It was learned in the post-intervention phase that the LSQ was only administered to those students who had a scheduled appointment. Consequently, of the twenty-two charts analyzed in the post-intervention phase, the LSQ was included in only about half of them. Thus, many potential opportunities for evaluating the utility of this tool were missed. It was concluded, in the post-intervention chart analysis, the staff interventions of introduction of the LSQ and education did not result in more rapid or thorough evaluations by staff Implications of this program evaluation include the need for more educational offerings for staff in regards to drugs and alcohol assessment and the need for ongoing program evaluation. To the extent that these issues are not addressed, assessment opportunities potentially valuable for planning early intervention strategies are being missed. In order to assist students in maximizing health, particularly in relation to drug and alcohol use, these issues must be addressed.


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