For the past six years, the Division on Addiction has collaborated with the Foundation for Advancing Alcohol Responsibility (FAAR) to develop a mental health screening and assessment tool that can be used in programs that work with DUI offenders and beyond. Today, we are excited to be able to make that tool, the Computerized Assessment and Referral System (CARS), freely available to the public.
The impetus for such a tool grew out of our NIH-funded research on mental health among repeat DUI offenders. We found both that these offenders had elevated rates of multiple mental health disorders compared to the general population, and that DUI programs did not have the resources or tools to screen for and assess these disorders. Additional research showed that this psychiatric comorbidity (i.e., presence of multiple mental health issues) was associated with criminal re-offense among DUI offenders. To help counselors involved in our initial studies, we built a report generator that could provide client-level output from the research tool we were using for the study, the Composite International Diagnostic Interview (CIDI). This initial report generator was cumbersome, limited, and required multiple pieces of proprietary software to run, but it was a start. The idea for CARS was born!
With funding from FAAR, we were able to take this pilot report generator and develop it into a fully functional assessment and referral system that adapts content from the internationally-validated CIDI, runs on open source software, includes a DUI-specific module, and generates individually-tailored and geographically-tailored reports at the click of a button.
We initially worked with Dr. Ron Kessler and his team at the Harvard School of Public Health to adapt content from the CIDI for use in CARS. This helped to ensure that the questions in CARS assess for each mental health disorder as accurately as possible. This also allowed us to make comparisons between data we collected with CARS and data collected through the National Comorbidity Survey-Replication, a general population study that used the CIDI.
We have now implemented CARS at multiple DUI programs within the Commonwealth of Massachusetts, and six pilot programs nationally. After many rounds of development, testing, implementation, feedback, and modification, our last step has been to create a web portal to host CARS and provide all the necessary information for its use. Please take a few minutes to explore the site. In addition to the information you need to download and run CARS, it provides information about our DUI research, the development of CARS, and our plans for a CARS data repository once programs begin to use the tool.
This project would not have been possible without the support of FAAR, the collaboration of Dr. Ron Kessler, Nancy Sampson, and their team, and the input from countless counselors, administrators, and clients. We hope that CARS is able provide a valuable service to programs and clients everywhere!