What is the system challenge?

A 2006 evaluation of assessment practices in Ontario’s publicly-funded addiction treatment system (Rush, B. and Martin, G. 2006) found significant variation in the tools used to assess individuals accessing service and also in the length of time taken to complete their assessments.

The evaluation also revealed that assessments were often conducted after a referral decision had already been made, making the assessment an administrative activity rather than a clinical one involving a rational, evidence-informed basis for treatment planning and referral.

The latest research suggests the need for addiction sector screening and assessments to focus on concurrent disorders.

What are we doing about it?

With support from the Provincial System Support Program at the CAMH, the Staged Screening and Assessment process is being implemented across Ontario's publicly-funded addiction programs. The process has four parts (three screening tools and a First Stage Assessment - see below).

  1. The first stage screener, Global Appraisal of Individual Needs – Short Screener (GAIN-SS), quickly identifies possible mental health and substance use issues requiring further exploration.
  2. If the responses to the GAIN-SS raise concerns about potential mental health issues, the second stage screeners are used to gather more information. The screeners are the Modified Mini Screener (MMS) for adults, and the Problem Oriented Screening Instrument for Teens (POSIT) for those 17 and under.
  3. The Global Appraisal of Individual Need Quick3 Motivational Interviewing Ontario (GAIN Q3 MI ONT) is a comprehensive assessment allowing the client to share their life circumstances across a broad range of areas, with a particular focus on substance use. This assessment and the auto-generated clinical reports provide a sound foundation for treatment planning and referral decisions.
SS&A Stages
SS&A diagram illustrating each assessment stage and applicable screen based on age group.
?What's this?

Full Implementation

SS&A is currently being implemented across the province. As of April 2017, all LHINs are participating and more than 150 agencies are engaged at various stages in training, certification and implementation. Training and certification will be provided to more than 1,500 service providers by the time full implementation is reached.

Who is involved?

SS&A implementation involves engagement with all LHINs and funded addiction service providers across Ontario. Training and certification will be provided to more than 1,500 service providers by the time full implementation is reached. Tens of thousands of service users will ultimately benefit from the increased quality of assessment and treatment planning.

How do we know it works?


agencies involved in implementation activities to date


staff trained and about 500 certified


GAIN Q3 MI ONT assessments completed provincially

Next Steps

SS&A implementation will continue to be supported by the Provincial System Support Program at the CAMH. The focus moving forward will be on transitioning the system to the use of these tools in everyday practice.


For more information, please contact:

Derek Chechak, Implementation Manager, PSSP