There is substantial evidence that there is a high prevalence of co-occurring substance use disorders as well as history of trauma among persons admitted to acute psychiatric settings. Professional literature suggests that these factors are under identified yet integral to current psychiatric status and should be assessed in order to develop appropriate treatment (Ziedonis, 2004, NASMHPD, 2005). Similarly, persons admitted to inpatient settings require a careful assessment of risk for violence and the use of seclusion and restraint. Careful assessment of risk is critical to safety and treatment. Effective, individualized treatment relies on assessments that explicitly recognize patients’ strengths. These strengths may be characteristics of the individuals themselves, supports provided by families and others, or contributions made by the individuals’ community or cultural environment (Rapp, 1998). In the same way, inpatient environments require assessment for factors that lead to conflict or less than optimal outcomes.

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• National Guideline Clearinghouse
• American Psychiatric Association
• National Association of State Mental Health Program Directors (NASMHPD)
• National Association of Psychiatric Health Systems (NAPHS)

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• American Psychiatric Association. (2003) Practice guideline for the assessment and treatment of patients with suicidal behaviors. Arlington (VA): American Psychiatric Association. http://www.guideline.gov/summary/summary.aspx?doc_id=4529
• Lyons JS, Uziel-Miller ND, Reyes F, Sokol PT (2000). Strengths of children and adolescents in residential settings: Prevalence and associations with psychopathology and discharge placement. Journal of the American Academy of Child & Adolescent Psychiatry, Vol 39(2): 176-181.
• NASMHPD. (2005) Position Statement on Services and Supports to Trauma Survivors. Alexandria, VA: NASMHPD.
• Rapp CA (1998). The strengths model: Case management with people suffering from severe and persistent mental illness. London: Oxford University Press.
• Ruiz P (2004). Addressing Culture, Race, & Ethnicity in Psychiatric Practice. Psychiatric Annals, Vol 34(7): 527-532.
• Ziedonis DM (2004). Integrated treatment of co-occurring mental illness and addiction: Clinical intervention, programs, and system perspectives. CNS Spectrums 9(12): 892,894-904,925.)

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