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13 Law & Hum. Behav. 1 (1989)

handle is hein.journals/lwhmbv13 and id is 1 raw text is: Law and Human Behavior, Vol. 13, No. 1, 1989

Screening for Severe Mental Disorder
in Jails
The Development of the Referral Decision Scale*
Linda A. Teplint and James Swartz$
Despite the demonstrated prevalence of severe mental disorder among jail detainees and the legal
mandate to provide mental health services, most jails do not have the resources to incorporate tradi-
tional, time-consuming psychological assessment techniques into their routine intake process. As a
result, a number of mentally ill jail detainees remain undetected and untreated. This study outlines the
development of the Referral Decision Scale (RDS), which detects persons who have a high prob-
ability of having a severe mental disorder so that they can be given a complete diagnostic evaluation.
The 14-item RDS was statistically derived using discriminant analysis from data collected via the
NIMH Diagnostic Interview Schedule on 728 randomly selected male jail detainees and then validated
on 1,149 prison inmates. The final validated version of the RDS had an overall sensitivity of 0.791,
specificity of 0.987, and positive and negative predictive value of, 0.791 and 0.013, respectively. Since
these statistics far exceed current detection rates, the RDS is likely to facilitate the diversion of
mentally ill detainees in situations where it is impractical to administer psychological examinations to
all incoming inmates. Training requirements for the RDS and directions for future research are dis-
* This research was supported in part by National Institute of Mental Health under grant No.
R01MH37988. We would like to thank Karl Kilgore, Stuart Michaels, John Lyons, Karen Abram,
Richard White, and Christine Davidson for their statistical insights and helpful comments. James
Collins is due special thanks for making his North Carolina prison data available. We are also
grateful to Philip Hardiman, Thomas Monahan, and Ronald Simmons for their cooperation with the
data-collection process. Reprint requests should be sent to: Linda A. Teplin, Ph.D., Northwestern
University Medical School, 215 E. Chicago Ave., Suite 708, Chicago, Illinois 60611.
t Department of Psychiatry and Behavioral Sciences and Psycho-legal Studies Program, Northwest-
ern University Medical School, and Northwestern Memorial Hospital.
$ Treatment Alternatives to Street Crime, Inc., Chicago, Illinois.

0147-7307/89/0300-0001$06.00/0 © 1989 Plenum Publishing Corporation

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