Clinician Experiences With a GAIN-SS Adapted Mental Health and Substance Use Screener in a Community Mental Health Setting in British Columbia, Canada
Francis Kato, Susan Chong, Mohamed IbrahimBackground:
Standardized screening tools are widely used to support early identification and triage in mental health and substance use (MHSU) services. However, little is known about how clinicians experience such tools in high-pressure community settings, where structural vulnerability and clinical complexity are common.
Methods:
We conducted in-depth interviews with 13 clinicians at a centralized MHSU intake center in British Columbia using interpretive description and reflexive thematic analysis. The aim was to examine how a locally adapted Global Appraisal of Individual Needs—Short Screener-based screener was used and understood in real-world practice.
Findings:
Clinicians expressed mixed understandings of the screener’s purpose, noting tensions between administrative and clinical roles. Most valued structured tools in principle but found the screener misaligned with relational care because its structured fields did not consistently preserve narrative context or connect clearly to referral actions. Training and implementation support varied, and several participants wanted clearer communication, follow-up, and better workflow integration. Clinicians proposed improvements including narrative fields, embedded referral actions, and collaborative implementation.
Conclusions:
Effective implementation of MHSU screeners requires more than tool design. Contextual fit, relational alignment, and sustained clinician engagement are also required. Findings underscore the need for collaborative implementation, iterative learning, and integration that supports rather than disrupts clinical reasoning and client-centered care.