Mental health screening is an important — and initial — step in the assessment and treatment of behavioral health issues. It differs from assessment, diagnosis and symptom monitoring in important ways. Let's examine the concept of mental health screening, the ways it differs and how behavioral health organizations should approach selection of the mental health screening tools that will best serve them and their patients.
What is Mental Health Screening?
Screening is used as a means of identifying people who may be at risk for certain behavioral health conditions or disorders. But that's not all. As the American Psychological Association (APA) notes, screening is "part of comprehensive healthcare and population health as described by the Patient Protection and Affordable Care Act.” Screening can point to the need for additional evaluation and may be conducted as part of a routine clinical visit by clinicians or support staff with the appropriate training.
Today, screening may also be aided by technology, with providers leveraging tools to screen their patients or with patients using self-administered electronic solutions. Importantly, as the APA indicates, screening “is neither definitively diagnostic nor a definitive indication of a specific condition or disorder.”
Understanding that providers and patients can both use screening technology that's currently available, this begs the question: Why are screening tools important in mental health? Such tools better ensure that patients are evaluated at an early point in their care so that the stages of their behavioral healthcare that follow — assessment, diagnosis, and symptom monitoring — will be more appropriate and effective.
Mental Health Assessment, Diagnosis, and Symptom Monitoring
While screening serves a multitude of purposes, it's best supported by these subsequent stages. Following screening, assessment offers a more detailed look at an individual and their functioning, integrating the results of various psychological tests or screening tools as well as clinical interviews and observations of the patient.
Diagnosis can be the result of screening and assessment, providing an indication of what condition the patient is suffering from. Once a diagnosis is determined, clinicians will work with the patient to create a treatment plan and then monitor symptoms through screening tools and self-assessment. A process model that walks providers through this workflow can lead to better assessment, diagnosis and treatment of those who suffer from mental illness.
Common Behavioral Health Disorders Identified with Mental Health Screening
There are numerous behavioral health disorders that may be identified during the initial screening process. According to Medline Plus, these disorders include:
- Depression and mood disorders
- Anxiety disorders
- Eating disorders
- Attention deficit hyperactivity disorder (ADHD)
- Post-traumatic stress disorder (PTSD)
- Substance abuse and addictive disorders
- Bipolar disorder (previously referred to as manic depression)
- Schizophrenia and psychotic disorders.
Frequently Used Mental Health Screeners
There is a wide range of mental health screening tools available. Some of the most common types of mental health screening tools for adults include:
- Patient Health Questionnaire (PHQ9), which is used to screen for symptoms of depression.
- General Anxiety Disorder-7 (GAD7), which is used to screen for symptoms of anxiety.
- Columbia Suicide Severity Rating Scale (C-SSRS), which is used to assess suicide risk.
- General Practitioner Assessment of Cognition (GPCOG), which is used to screen for cognitive impairment in primary care settings.
Note: Just because a screening tool is common does not necessarily mean it's the best option for providers. For example, the PHQ9, when used to screen for mental illness, may contribute to the prevalence of misdiagnosis for major depressive disorder because it only screens for depression.
There are also mental health screening tools for youth. Some tools are specifically designed to be used with children and adolescents. These include:
- Vineland Adaptive Behavior Scales, which are used for diagnosing and classifying disorders such as autism spectrum disorder and developmental delays in children.
- Mini-International Neuropsychiatric Interview (M.I.N.I.) KID, which is a structured interview to help diagnose the most common psychiatric disorders in children, while the M.I.N.I. is the version designed for adults.
What Makes a Good Mental Health Screening Tool?
When screening for mental health disorders, it’s important to understand that not all tools are created equal. In other words, some are more effective and efficient than others. Understanding the qualities to look for when reviewing a mental health screening tools list will better help ensure the tools selected and used within your organization are the most appropriate for your providers and patients.
To properly evaluate the types of mental health screening tools and the value of these tools, Emory University School of Medicine identifies four key qualities:
- Reliability: whether the tool produces consistent results
- Validity: the ability to consistently discriminate or distinguish between an individual with a disorder and one without
- Sensitivity: the accuracy of the tool in identifying the disorder
- Specificity: the accuracy of the tool in identifying those who do not have a disorder
The best mental health screening tools embody each of these characteristics and thus provide confidence in the tools’ ability to appropriately screen and assess patients.
Selecting Mental Health Screening Tools
Screening is a critically important part of the process of identifying and properly treating mental health disorders. The first step is to identify the mental health screening tools that will instill confidence that patients will be appropriately evaluated. Starting from this foundation will help ensure that assessment, diagnosis, treatment and monitoring can be implemented effectively, leading to positive outcomes for patients.
Is your organization looking to strengthen how you support the behavioral health needs of your patients? Contact nView today. You'll learn how our intelligent behavioral health workflow engine is providing actionable data that's leading to better decisions and ultimately healthier patient minds.