title: Service Use and Self-Reported Symptoms Among Persons With Positive PTSD Screens and Serious Mental Illness.
abstract: OBJECTIVE
  Although many studies have reported higher rates of trauma exposure and posttraumatic stress disorder (PTSD) among persons with severe mental illness, the screening, diagnosis, and treatment of PTSD in public mental health centers remain at a suboptimal level and PTSD is often overlooked and untreated. This study used routine PTSD screening and service use data in electronic medical records to determine the association of PTSD, psychiatric symptoms, and service use in a sample of individuals with serious mental illness in a community-based treatment setting.
  
  
  METHODS
  The sample included 1,834 active clients between January 2007 and November 2010 who were screened for PTSD and who completed the 24-item Behavior and Symptom Identification Scale (BASIS-24). Service data included services provided a year before and a year after the screening date.
  
  
  RESULTS
  PTSD was associated with more severe psychiatric symptoms and increased no-show rates but not with increased service use or use of high-intensity services. PTSD likelihood interacted with race in accounting for elevated scores among African Americans on the psychosis domain of the BASIS-24.
  
  
  CONCLUSIONS
  PTSD screening is feasible and recommended in service environments and may contribute significantly to better understanding of racial-ethnic and other differences in service use and diagnostic practices.
authors: Dr. Minsky and Dr. Gara are with the Department of Quality Improvement, Rutgers University Behavioral Health Care, Piscataway, New Jersey (e-mail: sminsky@ubhc.rutgers.edu ). Dr. Minsky and Dr. Gara are also with the Department of Psychiatry, Rutgers University, Piscataway, where Dr. Silverstein is affiliated. Dr. Lu is with the Department of Psychiatric Rehabilitation and Counseling Professions, Rutgers University, Scotch Plains, New Jersey. Dr. Gottlieb and Dr. Mueser are with the Center for Psychiatric Rehabilitation, Boston University, Boston.
authors: Shula K
authors: SK
authors: Minsky
authors: Dr. Minsky and Dr. Gara are with the Department of Quality Improvement, Rutgers University Behavioral Health Care, Piscataway, New Jersey (e-mail: sminsky@ubhc.rutgers.edu ). Dr. Minsky and Dr. Gara are also with the Department of Psychiatry, Rutgers University, Piscataway, where Dr. Silverstein is affiliated. Dr. Lu is with the Department of Psychiatric Rehabilitation and Counseling Professions, Rutgers University, Scotch Plains, New Jersey. Dr. Gottlieb and Dr. Mueser are with the Center for Psychiatric Rehabilitation, Boston University, Boston.
authors: Weili
authors: W
authors: Lu
authors: Dr. Minsky and Dr. Gara are with the Department of Quality Improvement, Rutgers University Behavioral Health Care, Piscataway, New Jersey (e-mail: sminsky@ubhc.rutgers.edu ). Dr. Minsky and Dr. Gara are also with the Department of Psychiatry, Rutgers University, Piscataway, where Dr. Silverstein is affiliated. Dr. Lu is with the Department of Psychiatric Rehabilitation and Counseling Professions, Rutgers University, Scotch Plains, New Jersey. Dr. Gottlieb and Dr. Mueser are with the Center for Psychiatric Rehabilitation, Boston University, Boston.
authors: Steven M
authors: SM
authors: Silverstein
authors: Dr. Minsky and Dr. Gara are with the Department of Quality Improvement, Rutgers University Behavioral Health Care, Piscataway, New Jersey (e-mail: sminsky@ubhc.rutgers.edu ). Dr. Minsky and Dr. Gara are also with the Department of Psychiatry, Rutgers University, Piscataway, where Dr. Silverstein is affiliated. Dr. Lu is with the Department of Psychiatric Rehabilitation and Counseling Professions, Rutgers University, Scotch Plains, New Jersey. Dr. Gottlieb and Dr. Mueser are with the Center for Psychiatric Rehabilitation, Boston University, Boston.
authors: Michael
authors: M
authors: Gara
authors: Dr. Minsky and Dr. Gara are with the Department of Quality Improvement, Rutgers University Behavioral Health Care, Piscataway, New Jersey (e-mail: sminsky@ubhc.rutgers.edu ). Dr. Minsky and Dr. Gara are also with the Department of Psychiatry, Rutgers University, Piscataway, where Dr. Silverstein is affiliated. Dr. Lu is with the Department of Psychiatric Rehabilitation and Counseling Professions, Rutgers University, Scotch Plains, New Jersey. Dr. Gottlieb and Dr. Mueser are with the Center for Psychiatric Rehabilitation, Boston University, Boston.
authors: Jennifer D
authors: JD
authors: Gottlieb
authors: Dr. Minsky and Dr. Gara are with the Department of Quality Improvement, Rutgers University Behavioral Health Care, Piscataway, New Jersey (e-mail: sminsky@ubhc.rutgers.edu ). Dr. Minsky and Dr. Gara are also with the Department of Psychiatry, Rutgers University, Piscataway, where Dr. Silverstein is affiliated. Dr. Lu is with the Department of Psychiatric Rehabilitation and Counseling Professions, Rutgers University, Scotch Plains, New Jersey. Dr. Gottlieb and Dr. Mueser are with the Center for Psychiatric Rehabilitation, Boston University, Boston.
authors: Kim T
authors: KT
authors: Mueser
mesh_terms: D000328:Adult; D000368:Aged; D015897:Comorbidity; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis* / Q000453:epidemiology; D008605:Mental Health Services / Q000706:statistics & numerical data*; D008875:Middle Aged; D009515:New Jersey / Q000453:epidemiology; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D057566:Self Report; D012720:Severity of Illness Index; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis* / Q000453:epidemiology