Staff in each jurisdiction should be properly trained to use whatever specific instruments have been adopted or designed for their use. Where tools are adopted from outside sources, the vendor or developers should be engaged to provide technical assistance regarding the proper administration of their instruments. Even if the screening or assessment tool has been validated, staff members who administer it must be able to generate reliable results; otherwise, the tool cannot be considered valid for use. Reliability can be measured by having the scores of a sample of prisoners re-computed by another person. If both testers produce the same scores in at least 80 percent of cases, and produce the same overall results in at least 90 percent of cases, then the administration of the instrument is reliable.

Medical assessments should be always be performed by trained clinicians, whether they are corrections or community-based providers, or some combination of the two. These clinicians should collaborate with corrections staff to ensure a thorough assessment that comprises both medical and public safety components for decisions regarding discharge from incarceration (as in the following example) and/or in-prison treatment and programming.

Example: DuPage County Probation Department and DuPage County Health Department (AZ)

DuPage County pairs clinicians and probation officers to go to local jails or prisons to assess inmates, focusing on public safety and health and mental health issues. Together, the partners also prepare a discharge plan for the courts. When appropriate, the individual may be released early into treatment.

Self-administered tools should never entirely replace critical observations by staff. Correctional or clinical staff should remain responsible for asking directed questions and observing for signs of mental illness or substance use disorders at the time of intake and throughout the period of incarceration. Training staff for such ongoing responsibilities is essential.