Citation

Sachs-Ericsson NJ, Ciarlo JA. Eval. Program Plann. 1992; 15(2): 149-164.

Copyright

(Copyright © 1992, Elsevier Publishing)

DOI

10.1016/0149-7189(92)90005-F

PMID

unavailable

Abstract

The Colorado Social Health Survey (CSHS) was designed to generate need prevalence rates for alcohol, drug abuse, and mental health (ADM) services using three different measures of need--diagnosable disorders, dysfunction in everyday living, and demoralization. Only the first of these measures was dichotomous, allowing clear specification of which survey respondents qualified as "cases" of need. For the CES-D scale-based measure of demoralization, a widely accepted cutting score established by other researchers was used to determine "caseness." For everyday dysfunction scales, three different methods of designating cases among respondents were studied--a clinical judgment approach, a statistical deviation approach, and a patient criterion groups approach. The clinical judgment approach used the respondent's endorsement of at least two "critical" dysfunction items previously judged by research clinicians to indicate reasonably clear need for ADM services. The statistical deviation approach involved a respondent scoring in the highest 10% of the general population sample on two or more scales assessing dysfunction in different domains of everyday functioning. The criterion groups approach was based on a respondent scoring at or above the median score for CSHS outpatient and inpatient comparison groups on at least two domain dysfunction scales. Results for all procedures were examined for validity, using criteria ranging from agreement with the epidemiological literature to comparisons with dysfunction ratings for samples of Colorado public mental health system outpatients and inpatients. On the basis of best performance against these criteria, the clinical judgment caseness-determination procedure was chosen as the primary method for designating respondents as dysfunctional in everyday living for all phases of this needs-assessment study. The statistical deviation criterion was used as a "backup" caseness-determining procedure.