Pre-Screening in Primary Care Benefits Veterans



A study recently published in General Hospital Psychiatry found that veterans who received behavioral health screening in primary care are typically provided with adequate follow-up care. However, the care provided in all settings can be improved, along with supplementary efforts to align screening and treatment. The study examined primary care screening for depression, post-traumatic stress disorder (PTSD), and alcohol misuse at a U.S. Department of Veterans Affairs medical center.

Researchers evaluated 3 mental health screening tests given in 2011 to primary care patients who did not have prior behavioral health problems. They found 3,272 out of the 20,682 patients screened positive for one or more behavioral health disorders. Of the patients with positive screens, 12% screened positive for PTSD, 16% screened positive for depression, and 84% screened positive for alcohol misuse. The study found many patients received appropriate treatment in the primary care setting and those identified with more severe illness were more likely to receive care in a mental health setting. Furthermore, patients with positive screens for PTSD and depression who went on to be seen in mental health clinics received care that was consistent with treatment guidelines for that disorder. Patients identified with alcohol misuse did not receive recommended guideline medications in any care setting. A researcher noted the finding could be misleading since a positive screen on the screening tool identifies both alcohol misuse and alcohol dependence, but the two problems have different recommended treatments. 

Pre-screening in primary care allows care providers to identify behavioral health conditions that would often go undiagnosed, as well as identify patients who may not seek services or wait to seek services until symptoms are more severe.

Rick Hafer, Ph.D, clinical professor of psychiatry and vice chairman of clinical services in the department of psychiatry at the University of Wisconsin School of Medicine and Public Health stated, “Early detection and treatment for mental health is similar to other medical conditions. Early intervention leads to more effective, efficient care.  Since more than 60% of behavioral health conditions are treated in primary care, it is important to develop pre-screening tools to better evaluate mental health conditions and early intervention.”

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