This entry defines comorbidity and similar terms used in various fields of practice. It addresses the prevalence of comorbidity, suggests explanations for comorbidity, and discusses integrated treatment for comorbid conditions and the importance of the concept of comorbidity in social work practice.
Diana M. DiNitto
Continuing a history of inequity, private insurers have placed restrictions and limitations on coverage for mental health conditions making access to treatment services increasingly more challenging. A state-by-state advocacy movement has led to the enactment of various state laws to require mental health parity. With the Clinton Administration’s attempt at health care reform, mental health parity became part of the health reform debate and led to the passage of the Mental Health Parity Act of 1996. The inadequacies of this law were partially corrected in the Mental Health Parity and Addiction Equity Act of 2008, which included mandated coverage for substance use conditions. The Obama Administration in 2011 included these provisions in the Patient Protection and Affordable Care Act, which does not require compliance monitoring nor does it provide a definition for “mental health,” which leaves insurers to define it and hence determine what coverage will actually be available.
Lori K. Holleran Steiker
This article provides an overview of screening adolescents for substance use, misuse, and substance use disorders. It covers the practical and empirical considerations when working with youth around issues of drugs and alcohol. Four reliable and valid screening tools are discussed: Alcohol Use Disorders Identification Test (AUDIT), CRAFFT, Rutgers Alcohol Problem Index (RAPI), and Problem-Oriented Screening Instrument for Teenagers (POSIT). The tools and techniques are drawn from evidence-based theoretical frames and practices, including close attention to the recent adolescent (Screening, Brief Intervention, Referral, and Treatment (SBIRT) resources.
Elizabeth C. Pomeroy, Danielle Parrish, Angela M. Nonaka, and Kathleen H. Anderson
This article reviews existing knowledge on the assessment of children with fetal alcohol spectrum disorders (FASD) and available screening, prevention, and intervention services. The wide range of preventable conditions associated with FASD throughout the life cycle is described, along with associated high-risk maternal behaviors. In addition, cultural and social determinants are discussed, in an effort to inform social work practice. The differentiation of FASD and protective factors that have been identified as reducing negative outcomes for children and their families affected by prenatal alcohol exposure are also explained. Finally, multidisciplinary and culturally appropriate prevention services are emphasized as well as early diagnosis and strength-based intervention strategies.