According to the 2020 National Survey on Drug Use and Health, 40.3 million Americans aged 12 or older had a substance use disorder (SUD) in the past year; almost half of these people also suffer from a mental illness. How many of them are walking around undiagnosed or incorrectly diagnosed? Chances are it's millions.
Given this data, Proem Behavioral Health – where I serve as CEO – is actively working to equip primary care providers with clinical workflow efficiencies. It is time we comprehensively screen for and appropriately treat both SUD and the underlying mental illnesses that lead to addiction.
Integrating Mental Health Screenings into Primary Care Clinical Workflows
For any screening tools to be effective in improving patient outcomes, their use must become established in routine clinical practice. This challenges all clinic staff, individually and collectively, to make some degree of change in their ways of working and interacting with colleagues and patients.
Practices also need to decide how often the screening will occur, where the screening data will be stored, how results will be communicated to all care team members, and how the follow-up strategy will be documented.
A 2018 systemic review on Screening for Behavioral Health Conditions in Primary Care Settings found that while e-screening in primary care is effective in detecting youth psychosocial issues and enabling timely brief interventions, common barriers (a lack of time, training, tools, and staff and discomfort in raising sensitive issues) to their use persist.
What is a Comprehensive Mental Health Screening?
To put it simply, a comprehensive mental health screening is one tool to assess for multiple mental health conditions.
A wide range of mental health conditions – including depression, anxiety, post-traumatic stress disorder (PTSD), and attention deficit hyperactivity disorder (ADHD) – increase the risk of a substance use disorder (SUD).
With Proem, primary healthcare providers can rely on one solution built into their workflow to assess SUDs at the same time as the most common adult and pediatric DSM-5 conditions so they can get to the underlying conditions that may be causing the SUD.
Proem digital screeners can be completed in just three minutes before an appointment at the patient’s convenience or in a care setting based on preferred workflow. The screeners help quickly and accurately identify people who need further evaluation – catching mental illness and identifying comorbidities early on.
Today’s Typical Approach to Screening for Mental Illness Isn’t Working
The peak age of onset for mental disorders is 14.5 years with 50% of lifetime mental illnesses taking root by the age of 18. Often, patients – especially adolescents with mental illness – lack the insight, judgment, or comfort necessary to openly discuss their problems, making diverse mental health screening tools impactful in helping uncover the issues they are facing.
A brief 9-question depression questionnaire called the Patient Health Questionnaire-9 (PHQ-9) is today's typical approach to screening for mental illness in primary care; it's likely to miss any other mental illnesses that could present with depression as a co-occurring condition.
Using the appropriate mix of screening tools is more likely to yield accurate reporting because a more comprehensive picture can yield better insight into the most appropriate next steps for achieving an accurate diagnosis and building an appropriate treatment plan.
Only after we start integrating comprehensive screening into existing clinical workflows can begin to close one of the biggest gaps in mental health care: more timely identification of a mental illness.
About Proem Behavioral Health
Proem Behavioral Health, formerly nView Health, provides the premier clinical workflow software engine that helps behavioral health providers and research organizations efficiently and accurately screen, test, and measure treatment success for those suffering from mental illness. Proem is the exclusive digital licensee worldwide of gold-standard, evidence-based screening solutions, structured interviews, and post-diagnosis severity measurement scales to monitor patient outcomes.
