4 Mental Health Screening Tools for Primary Care Providers

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July 21 2023 - Primary care providers(PCPs) are generally the first point of contact for undiagnosed illnesses and everyday health issues. Visiting them does not sound very alarming and the patient is generally comfortable, less stressed, and open to medications and suggestions given by the doctor or the nurse.

According to Statista, as of September 2021, more than a million professional physicians were practicing in the United States. The number of specialist physicians stood at a total of over 550,300.

If PCPs get equipped to diagnose the symptoms of common mental health concerns, it will help in issues getting addressed timely and prevent them from getting out of hand. This can help the patients save money and effort in their treatment.

For professionals, the inclusion of mental healthcare in primary caregiving helps them to maintain Continuity of Care. This continuity helps build a loyal rapport with the patients. In recent times, many healthcare professionals have sought this integrated model of work. Championing the paradigm of inclusive healthcare requires comprehensive education and training.

If you are someone who wishes to serve society, multiple online nursing programs can help you gain expertise in this domain. You can even specialize in psychiatric nursing to work in the domain of mental health. The education in primary care coupled with several mental health screening tools can aid doctors and nurses in their pursuit of holistic care.

Nurses and other healthcare professionals can use modern screening tools to diagnose initial symptoms of common mental and substance use disorders like depression and alcohol addiction. This article will discuss the four most effective mental health screening tools available for primary care providers.

Patient Health Questionnaire-9 (PHQ-9)

The Patient Health Questionnaire-9 (PHQ-9) has proven to be an effective and reliable way of identifying and diagnosing depression in primary care settings. This questionnaire consists of nine questions that assess the occurrence and intensity of symptoms across two weeks.

The PHQ-9 has demonstrated impressive sensitivity and specificity in detecting depression, making it a priceless instrument for primary care practices. They can administer the PHQ-9 during regular visits to detect the presence and severity of depression and ensure appropriate treatment.

It facilitates thorough assessment so that surfacing mental health issues do not go unnoticed. Moreover, the PHQ-9 is suitable for overseeing treatment progress and evaluating the efficacy of interventions, allowing professionals to make necessary adjustments.

Generalized Anxiety Disorder-7 (GAD-7)

Generalized Anxiety Disorder is a prevalent mental health condition that is characterized by overthinking and worrying about everyday life. The GAD-7 is a self-answerable set of 7 questions to evaluate the severity of anxiety symptoms.

The questions probe areas such as restlessness, difficulty concentrating, and physical manifestations related to tension and sleep issues. Responses to the questions range from "not at all" to "nearly every day," and numerical values get assigned to create a total score of 0 to 21.

The score is then interpreted as follows:

0 to 4: Minimal anxiety
5 to 9: Mild anxiety
10 to 14: Moderate anxiety
15 to 21: Severe anxiety

The GAD-7 is highly efficient in assessing symptom fluctuations, thereby making it a valuable asset in assessing the effectiveness of treatment and its results.

Alcohol Use Disorders Identification Test (AUDIT)

AUDIT is a widely recognized and validated tool to identify individuals battling alcohol use disorders. Developed by the World Health Organization (WHO), it can be put into extensive use in hospital-based clinics and community health centers.

The AUDIT questionnaire comprises three sections.

The first set of three questions targets the user's drinking habits and is centered around the quantity and frequency of alcohol consumption.

The second set of three questions focuses on dependence symptoms plaguing the drinker. These symptoms include increased tolerance to alcohol and failed attempts at cutting down or leaving alcohol. These markers indicate the user's level of dependency on alcohol.

The last section comprises four questions and highlights the negative consequences that come with excessive alcohol use. These items bring forth the social and behavioral impacts of alcohol consumption, like physical abuse, deteriorating interpersonal relationships, and blackouts.

Each question gets a score between 0 and 4, with higher scores indicating a higher level of concern regarding alcohol-related issues. Following the assessment, the categorization of alcohol users into different risk groups is based on their total score, which can range from 0 to 40. This classification determines the appropriate level of intervention or support required.

The test is very brief and precise. The AUDIT is fairly concise and user-friendly, making it well-suited for integration into primary care settings.

Primary Care-PTSD Screen(PC-PTSD)

According to the University of Indianapolis, primary care should emphasize empathy and patience. These values are extremely important, especially when dealing with post-traumatic stress disorder (PTSD) cases.

PTSD is a mental state of recurring shocks and fears triggered by memory flashes. It can occur in some people who experienced a shocking or dangerous event and cannot let go of the bitter memories.

PC-PTSD tool can help physicians detect PTSD symptoms in their patients through a questionnaire comprising four questions. These questions target the trigger points and track the associated symptoms.

When patients indicate a positive screen for PTSD symptoms, primary care providers can engage in a more comprehensive assessment to confirm the diagnosis and determine appropriate treatment options.

Conclusion

This article does not, in any way, look down upon independent mental healthcare practitioners. They are more equipped and better placed to diagnose and treat behavioral disorders. But, more often than not, due to social taboos and the high cost of therapy, people do not come out and embrace help.

In such cases, inclusive healthcare practices can bridge the gaps. Visiting a physician will never be taboo. So, if general healthcare practitioners assess mental health conditions and provide counseling to some extent, it can go a long way in easing the pressure on patients and help in treating issues that may have been ignored by them.

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