Psychiatric hospitalization has become telescoped, thus focusing on short-term acute care. Since discharge plans are needed on admission, occupational therapists must evaluate the patient quickly and succinctly. A screening tool was developed as a preliminary device to identify critical information in two major areas: patterns of skills and achievement or patterns of dysfunction in past and current occupational role; and the degree of balance or imbalance between leisure activities and those activities associated with occupational role. The screening tool, the Occupational Role History, was used in a pilot study on 20 adult inpatients at the UCLA Neuropsychiatric Institute. The results of the pilot study suggest that this tool is useful in establishing treatment priorities from an occupational therapy perspective.