The National Alliance on Mental Illness (NAMI) indicates that approximately 75% of lifetime mental health conditions begin by age 24. From the time symptoms appear until that individual is supported with appropriate interventions, the average gap in care is about 11 years in total.
Mental health screening tools used early and correctly can play a key role in limiting this gap in care. Earlier identification of mental health disorders has been shown to lessen long-term disability and lead to overall improved clinical outcomes.
According to findings from the National Health Interview Survey, nearly one in five individuals 18 years of age and older in 2019 experienced symptoms of depression in the two weeks prior to the survey. Further examination of the data reveals that the highest-risk populations for depression are women and all individuals aged 18 to 29. NAMI and the United States Preventative Services Task Force (USPSTF) recommend early screening for major depressive disorder (MDD) as a result of this disease prevalence.
One of the most common mental health screening tools for adults is the PHQ9 scoring interpretation. It is a clinically valid, nine-item screening tool that is patient-administered or administered by a mental health clinician to measure for MDD. Not only can the PHQ9 provide data on the patient’s last seven days of depressive symptoms, it can also help determine the severity of symptoms which a clinician can use to guide patient care.
Furthermore, the PHQ9 can be used at regular intervals along the treatment continuum to determine the improvement or stability of symptoms. PHQ9 was designed to screen for clinical depression, measure the severity of symptoms, and measure a patient's response to treatment. It tries to do so by asking patients to speak to how much they have been bothered by nine problems over the previous two weeks. Given how prevalent major depression is, this screening tool for clinical depression is useful for identifying patients who need further assessments.
One important note about the PHQ9: Even though it is intended to be used as a screening tool, the PHQ9 has increasingly been used as a diagnostic tool. In fact, sometimes this mental health questionnaire is used in therapeutic decision-making. When relied upon to make a diagnosis, use of the PHQ9 and other screening tools can actually do more harm than good.
For patients who screen positive for a mental health disorder, a more structured diagnostic interview may be warranted. For this, there are clinician-administered exams such as the Mini International Neuropsychiatric Interview (M.I.N.I). This is a clinically validated structured diagnostic interview developed by psychiatrists for the purpose of diagnosing MDD and six of its subtypes, as well as other DSM-5 conditions. Identification of these different subtypes early in treatment is important to determine prognosis and approach to treatment. Translated in over 70 different languages, the M.I.N.I is considered the most relied-upon diagnostic interview tool for depression in more than 100 countries.
Without the proper use of mental health screening tools, patients may not be able to articulate the symptoms they are experiencing. This is particularly true for adolescent populations. The effects of clinical depression on younger patients cannot be understated. For perspective, Medicaid programs have adopted the recommendations of the CDC and NAMI in requiring screening for mental health conditions in children. This federal law should be upheld for adolescent patients when seeking primary care and even in the school setting. These are good settings to perform proper screening for depression. Failure to screen may lead to delay in diagnosis and ultimately suboptimal timing of treatment.
In 2020, the 12th leading cause of death for all ages in the United States was suicide (learn other eye-opening statistics about suicide). Suicidal ideations and suicidal attempts represent a major contribution to premature mortality in our population, making interventions on this matter a public health imperative. One way to prioritize efforts toward suicide prevention is through leveraging screening tools and tracking scales such as the Sheehan – Suicidality Tracking Scale (S-STS).
The S-STS is a validated scale used in pediatric and adult populations. It has 14 core questions in addition to nine further contingent questions regarding suicidality. The questions can be administered by the clinician, self-administered by the patient or some combination of the two. Tools like the S-STS are important because they allow a clinician and patient to better monitor key features of suicidal behavior over time. Together with other screening tools for depression as well as clinical assessments performed by a trained mental health professional, the S-STS serves an essential role in the management of patients with suicidality.
With any mental health disorder, it's important to translate subjective patient data into objective information that a clinician and patient can track together. Screening tools and tracking scales permit an enhanced level of objective data collection. After all, how can you improve what you don’t measure?
Accessing a combination of multiple screening tools is imperative to helping providers quickly and accurately identify those who need further evaluations for mental health disorders. That's why Proem offers a comprehensive suite of solutions that can meet growing and evolving mental health screening needs. These solutions range from the M.I.N.I interviews to the Sheehan scales.
At Proem, we offer validated, reliable, and widely accepted clinical tools for a variety of purposes. Our evidence-based behavioral health engine uses automation to help providers connect the data they gather to an evidence-based process workflow that can drive measurable improvements in patient outcomes. Learn more about how our solution is helping make a difference for behavioral health providers and their patients, then schedule a demo to see firsthand how we can help you achieve even better patient outcomes.
