Substance Use Disorder Screening Capacity Lags Behind Depression Screening Capacity in Community Health Centers

• Author: Traci Rieckmann,Emily Jones
• Published date: 01 April 2018
• Date: 01 April 2018
• DOI: 10.1177/0022042617743255
• Subject Matter: Articles

https://doi.org/10.1177/0022042617743255

Journal of Drug Issues

2018, Vol. 48(2) 152 –164

© The Author(s) 2017

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DOI: 10.1177/0022042617743255

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Articles

Substance Use Disorder Screening

Capacity Lags Behind Depression

Screening Capacity in Community

Health Centers

Emily Jones1 and Traci Rieckmann2

Abstract

Despite their prevalence, screening for depression and substance use disorder (SUD) is often

not routinely practiced in primary care. This study uses a survey of community health centers to

identify characteristics associated with depression and SUD screening. In 2010, 76.9% of federally

qualified health centers routinely screened for depression, and about half of health centers

(54.1%) routinely screened for SUDs. Higher Medicaid caseload and region were associated

with routine screening for both depression and SUDs. SUD screening was also associated with

the percent of total staff comprised of behavioral health specialists, electronic health record

(EHR) adoption, urban location, and higher uninsured caseload. Implications include the need to

build SUD screening capacity, encourage the use of standardized screening tools, and monitor

SUD screening capacity in health centers in the future.

Keywords

screening, substance use disorder, depression, safety net, primary care

Introduction

Identifying and treating behavioral health conditions more effectively is a key strategy in many

initiatives designed to improve health care quality and transform the delivery system (Baird

et al., 2014; Levey, Miller, & deGruy, 2012). Despite their prevalence, depression and substance

use disorders (SUDs) are often not identified and treated in a timely manner, particularly in

underserved communities (Glied & Frank, 2009; Wang et al., 2005). Previous research has

focused on treatment capacity in specialty settings, not screening or treatment capacity for

depression and SUDs in primary care. In the midst of the current opioid epidemic (Gunter, Kurtz,

Bakken, & O’Connell, 2009), screening individuals for SUDs in primary care is a critical first

step to identifying patients who would benefit from treatment. This study examines screening

capacity in federally qualified health centers. Also known as “health centers,” these clinics pro-

vide primary care in medically underserved areas. Many health centers also provide mental

1The George Washington University, Washington, DC, USA

2Oregon Health & Science University, Portland, USA

Corresponding Author:

Emily Jones, Department of Health Policy and Management, Milken Institute School of Public Health, George

Washington University. 950 New Hampshire Avenue, NW, Washington, DC 20052, USA.

Email: Emilybjones@gmail.com

743255JODXXX10.1177/0022042617743255Journal of Drug IssuesJones and Rieckmann

research-article2017