Abstract
Background: Previous studies in Mexico undertaken at residential facilities for treating substance use disorders (SUDs) reported that the prevalence of Dual Disorders (DDs) is over 65%. DDs pose a major challenge for the Mexican health system, particularly for community-based residential care facilities for SUDs, due to the shortage of certified professionals to diagnose and treat these patients. Moreover, the lack of standardized algorithms for screening for and evaluating DDs to refer patients to specialized services (whether private or public) hinders timely care, delaying the start of integrated treatment. The use of new technologies provides a strategic opportunity for the timely detection of DDs through the development of standardized digital applications for the timely detection of DDs.Objective: To develop an app to screen for DDs, which will contribute to referral to specialized services in keeping with the level of severity of psychiatric and addictive symptomatology, and be suitable for use by community-based residential care facilities for SUDs.Method: The research project was implemented in two stages. Stage 1 involved obtaining the psychometric properties of the Dual Diagnosis Screening Interview (DDSI). Stage 2 consisted of two steps to test the Beta version of the app and the quality of version 1.0.Results: The DDS obtained sensitivity and specificity scores above 85%. The app and its algorithm to screen for and refer DDs proved to be efficient and easy to apply with satisfactory community acceptance.Conclusion: The app promises to be a useful screening tool at residential addiction treatment centers.
Highlights
Previous studies in Mexico undertaken at residential facilities for treating substance use disorders (SUDs) reported that the prevalence of Dual Disorders (DDs) is over 65%
The aim of this study is to develop an app to screen for DDs that will improve the services offered by community-based residential care facilities for SUDs in Mexico, using an algorithm to detect the degree of severity of psychiatric and addictive symptomatology, and to contribute to the detection, counseling and referral of patients to specialized services
Psychometric Properties of Dual Diagnosis Screening Interview (DDSI) According to the results, the most prevalent diagnoses were depression (35.2%), posttraumatic stress disorder (PTSD) (22.5%) and attention deficit/hyperactivity disorder (ADHD) (21.1%)
Summary
Previous studies in Mexico undertaken at residential facilities for treating substance use disorders (SUDs) reported that the prevalence of Dual Disorders (DDs) is over 65%. DDs pose a major challenge for the Mexican health system, for community-based residential care facilities for SUDs, due to the shortage of certified professionals to diagnose and treat these patients. The lack of standardized algorithms for screening for and evaluating DDs to refer patients to specialized services (whether private or public) hinders timely care, delaying the start of integrated treatment. The scientific literature has identified two broad categories to service access: personal characteristics and structural barriers. Personal characteristics include personal vulnerabilities associated with the symptomatology and severity of both psychopathological dimensions, in addition to the motivation to change and personal beliefs associated with preconceived ideas about health professionals, stigma and cultural differences [6]. The review identified the following structural barriers: service availability, DD identification, service provision, racial and ethnic disparities and last but not least, insurance policies [6]
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