When patients are concerned about a behavioral health issue, one of the first recommended steps is talking to a healthcare professional. Whether it's a primary care doctor or behavioral health specialist such as a psychologist, the practitioner may conduct a behavioral health assessment, also sometimes referred to as a behavioral health clinical assessment. Such an assessment can help identify behavioral health problems and assist the practitioner in figuring out the best way to address them.
What is a Behavioral Health Assessment?
A behavioral health assessment is designed to provide a doctor with a more complete picture of the way a patient thinks, feels, reasons, and remembers. It may be used to help providers:
- Diagnose behavioral health conditions such as anxiety, depression, schizophrenia, and eating disorders
- Evaluate cognitive disorders such as dementia
- Identify developmental problems such as learning disabilities and autism spectrum disorders
- Differentiate between behavioral and physical health problems
- Assess a person referred because of problems at school, work, or home
As we will see in the next section, behavioral health assessments typically consist of an interview, physical examination, written questionnaires, and lab tests. However, the particular tools used and the approach taken may vary with the individual being assessed. For instance, behavioral health tests for children will depend on their age and might include asking them to draw pictures to help express their feelings. Other behavioral health assessment tools may be specifically geared toward adults over 60 years old to help identify depression and cognitive impairment.
An initial behavioral health assessment may be followed by additional, more specific tests. The most recent version of the “Diagnostic and Statistical Manual of Behavioral Disorders (DSM Version 5)” lists more than 150 diagnoses. Some of these can be challenging to diagnose, especially for healthcare providers who are not behavioral health specialists, so further assessments may be necessary to refine a diagnosis.
Components of a Behavioral Health Clinical Assessment
Most behavioral health assessments contain similar basic components, although the specifics may be changed depending on the individual being assessed, the clinician doing the assessment, and the place where the assessment takes place.
Typically, a behavioral health assessment will consist of the following:
1) INTERVIEW: A doctor asks patients questions about their symptoms and concerns. These questions may cover personal or family history of behavioral health issues; lifestyle and personal history, including any sources of stress or trauma; and current thoughts, feelings, and behaviors. During the interview, the practitioner may also make note of a patient's appearance and behavior for clues to explain the patient’s symptoms.
The approach taken for verbal interviews should not only take into consideration a patient's age but many other factors, including social determinants of health (SDOH). SDOH can be defined as "… conditions in the places where people live, learn, work, and play that affect a wide range of health and quality-of life-risks and outcomes."
Concerning the effect of SDOH on behavioral health, the federal government's Healthy People 2030 initiative notes, "Several factors have been linked to behavioral health, including race and ethnicity, gender, age, income level, education level, sexual orientation, and geographic location. Other social conditions — such as interpersonal, family, and community dynamics, housing quality, social support, employment opportunities, and work and school conditions — can also influence behavioral health risk and outcomes, both positively and negatively. … A better understanding of these factors, how they interact, and their impact is key to improving and maintaining the behavioral health of all Americans."
2) PHYSICAL EXAM: A patient may receive a physical exam to help exclude physical causes, such as a neurologic problem, for behavioral health issues. In addition to the exam, a doctor may ask the patient about their general health history, any medications or supplements taken, family health history, and drug and alcohol use.
3) LAB TESTS: Since some physical conditions can present similar symptoms as behavioral disorders, a doctor may recommend that a patient undergo lab tests. These may include blood or urine tests to rule out anemia, a vitamin deficiency, or a thyroid disorder. If a doctor suspects a patient has a nervous system problem, they may undergo tests such as magnetic resonance imaging (MRI) or electroencephalogram (EEG).
4) WRITTEN QUESTIONNAIRES: A doctor may ask a patient to undertake a written questionnaire or verbal test to assess specific problems, such as depression; how well a patient can think, reason, and remember; or how well the patient can carry out activities of daily living, such as caring for oneself and going to work.
A Closer Look at Behavioral Health Assessment Tools
There are many different kinds of behavioral health questionnaires and assessments that clinicians can administer to their patients. The choice of questionnaires used may depend on the age of the patient, the patient’s symptoms, and even the background of the clinician.
Below are some examples of commonly used behavioral health questionnaires:
- Patient Health Questionnaire (PHQ-9): used to screen for symptoms of depression
- General Anxiety Disorder 7 (GAD7): used to screen for symptoms of anxiety
- Columbia Suicide Severity Rating Scale (C-SSRS): used to assess suicide risk
- General Practitioner Assessment of Cognition (GPCOG): used to screen for cognitive impairment in primary care settings
- Vineland Adaptive Behavior Scales: used for diagnosing and classifying disorders such as autism spectrum disorder and developmental delays in children
- Mini-International Neuropsychiatric Interview (M.I.N.I.): a structured interview to help diagnose the most common psychiatric disorders in adults and children
nView Health is the worldwide exclusive licensee for the M.I.N.I. as well as several other evidence-based behavioral health assessments including the Yale-Brown Obsessive-Compulsive Disorder Scale (YBOCS©), Children’s Yale-Brown Obsessive-Compulsive Disorder Scale (CYBOCS©), Body Dysmorphic Disorder Questionnaire (BDDQ©), and other measurement solutions. These short, structured interviews are designed to quickly identify the 17 most common adult DSM-V psychiatric disorders, 24 most common pediatric disorders, and other associated behavioral health disorders.
To learn more about how your organization can use nView solutions to quickly and accurately identify, help diagnose, and monitor, and document patient conditions and outcomes, contact us.