Ask the Institute: Understanding the difference between mental health screening and assessment

What’s the difference between a screening tool and an assessment tool? Ask any mental health clinician, and they might think you’re giving them a trick question, given how frequently the two terms are used interchangeably. But in fact, the two are quite different, and the distinctions matter. However, according to Tomiko D. Mackey, MSW, LCSW, and training fellow for NCA’s Institute for Better Mental Health Outcomes, “the names matter less than the purpose for which each is used.” She explains the purpose of each as follows:

Mental health screening tools are shorter and less detailed and typically utilize standardized questionnaires. They are often administered during the CAC intake, after the forensic interview, or before therapy services begin. Screeners are used for early identification of trauma-related symptoms, safety concerns, and give us a means to prioritize treatment of those with more urgent concerns.  Importantly, however, screening tools are not diagnostic – in other words, screening will let us know if the child or family member is experiencing trauma symptoms, and how urgent those symptoms may be. And, importantly, screening tools also tell us when children do not have trauma symptoms – not every child needs to be referred for therapy, and this is an important distinction for us to make.

One further distinction is that screening tools can be administered by clinicians, and they can also be administered by other staff such as victim advocates, with appropriate training. This makes screening tools more accessible for CACs that do not have clinicians on staff or readily available at all times.

“On the other hand,” says Mackey, “mental health assessment tools provide far more detailed information, and must be administered by a licensed professional.” Assessment measures help inform diagnosis and can confirm that an evidence-based treatment, like TF-CBT or EMDR, is the most appropriate modality to use. And although a screening tool may be completed in one sitting, assessment tools are usually conducted over several sessions. Assessment tools should be evidence-based, reliable, valid, and normed.

A screening tool may identify that a child has trauma symptoms; an assessment helps the clinician understand the trauma itself, and how best to provide treatment. Assessment measures are also helpful in other ways – clinicians frequently use assessments as a way to engage clients and caregivers in more dialogue and communication.

Mackey also emphasizes that it is best practice to consider screening tools and assessment tools together; both tools serve unique but complementary roles and together, create a strong system of care. And along those same lines, when appropriate, she urges clinicians to administer both tools to the child and to the parent/caregiver. Sometimes the findings align – but when they do not, that incongruence can provide important information for the clinician.

Despite using the terms interchangeably, the differences between screening tools and assessment tools matter. To learn more about both, and to learn about training opportunities for each, please visit NCA’s Institute for Better Mental Health Outcomes.