Global Appraisal of Individual Needs: Short Screener (GAIN-SSS)
Clinical Screening Questionnaires Training - page 3/10
Self-Rated Health (SRH) / Self-Rated Mental Health (SRMH)
YWHO Substance Monitoring Form (YSMF)
Introduction
The YSMF is a self-report tool influenced by research on the Outcome Questionnaire-45 (OQ-45), whereby items measuring the number of days in the past week individuals used alcohol and drugs were added to the full OQ-45 measuring psychological distress, interpersonal functioning, and contentment with social role functioning. Inspired by this modified questionnaire, the purpose of the YSMF is to measure the frequency of young people’s use of alcohol, cannabis, and other substances in the past week, as well as their experience of negative consequences, via a four-item brief self-report.
Why are we asking youth to complete this questionnaire?
Youth substance use is common on a national and international scale, although statistics vary depending on the substance being consumed. In Ontario in 2019, 41% of Grade 7-12 youth consumed alcohol, and 22% consumed cannabis, in the previous year. In addition, substance use co-occurs with mental health issues; Approximately one third of individuals diagnosed with a mental health disorder will also have a substance use disorder at some time in their lives, and vice versa. Moreover, in Canada, 25–50% of youth who die from suicide meet the criteria for having a substance use disorder. It is therefore critical to ask youth about their substance use frequency, to understand and validate their experiences, monitor changes over time, and incorporate information into plans to meet treatment goals. The YSMF enables youth to simply and quickly share this information regularly at the hub.
Responding to youth asking why they are being asked to complete this questionnaire:
These questions ask about how often you have had alcohol, cannabis (weed), or other drugs in the past seven days, and if you experienced any kind of negative consequences as a result (either directly from the substances, or indirectly like you missed school, got into a fight, were late for work etc.). Sometimes these are concerns for young people, and sometimes they are not, but asking about them lets us get a sense of how you’re currently doing with drinking or drugs, and then you can decide if there’s anything you might want to talk about here at some point.
Clinical Questionnaire:
At the hub, when youth are provided the questionnaire on an iPad (or possibly in hard copy form), they receive the following instructions:
| Looking back over the last week, including today, please answer the following four questions: |
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1. How many days in the past week have you used alcohol?
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2. How many days in the past week have you used cannabis?
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3. How many days in the past week have you used other drugs?
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4. In the past week how often did you experience negative consequences of using alcohol, cannabis, or other drugs?
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When do youth respond to these questions?
Young people are asked to complete this questionnaire at their first clinical visit, and subsequent clinical visits 8-29 days later. If young people’s subsequent clinical visit is 30 or more days later, they complete the GAIN-SSS - a slightly longer measure screening for substance use issues, as well as disordered eating, traumatic distress, disordered thinking, gambling, gaming, and internet overuse in youth.
Neither of these questionnaires is completed if youth visit the hub for service seven or fewer days after their last clinical visit.
What if youth don't understand a question?
If a young person requires assistance with an item due to developmental, cognitive, language, or other issues, try to provide these supports:
- Read all items aloud exactly as printed word for word, at an appropriate pace;
- If there is some misunderstanding, repeat the item;
- Determine which word is confusing and define the word, but try not to reword the question (it may alter the meaning of the question, as well as the response); and
- Do not suggest answers.
Scoring/Results:
How can I go over results with youth?
Responses are recorded automatically on the YWHO Data Collection platform, although there is no scoring. Service providers are able to view the responses regarding youth’s frequency of alcohol and drug use, and negative consequences, in the past week, to provide information regarding recent substance use prevalence, and inform collaborative treatment decisions. Service providers may also want to consider drug type (e.g., injection cocaine or heroin, nicotine) and intensity of adverse consequences (e.g., missing work, overdose).
There is no progress tracker, although past responses can be viewed for each youth to provide information over time.
Please remember that this screening instrument does not operate in isolation. Please take into account findings from other screening questionnaires, and use your clinical judgment and discussions with youth and their families to make the most appropriate decisions regarding assessment and interventions available at your specific YWHO site.
Video:
Global Appraisal of Individual Needs: Short Screener (GAIN-SSS)
Self-Rated Health (SRH) / Self-Rated Mental Health (SRMH)
