Mental health screening is an important 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 medical providers and behavioral health organizations should approach the selection of the mental health screening tools that will best serve them and their patients.
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.
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.
There are numerous behavioral health disorders that may be identified during the initial screening process. According to Medline Plus, these disorders include:
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:
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:
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:
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.
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.
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