Grant Merridy, Petersen Inge, Mthethwa Londiwe, Luvuno Zamasomi, Bhana Arvin
Centre for Rural Health, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa.
Health Systems Research Unit, South African Medical Research Council, Durban, South Africa.
Int J Ment Health Syst. 2022 Aug 23;16(1):44. doi: 10.1186/s13033-022-00554-7.
Screening tools for mental health disorders improve detection at a primary health care (PHC) level. However, many people with mental health conditions do not seek care because of a lack of knowledge about mental health, stigma about mental illness and a lack of awareness of mental health services available at a PHC facility level. Interventions at a community level that raise awareness about mental health and improve detection of mental health conditions, are thus important in increasing demand and optimising the supply of available mental health services. This study sought to evaluate the accuracy of a Community Mental Health Education and Detection (CMED) Tool in identifying mental health conditions using pictorial vignettes.
Community Health Workers (CHWs) administered the CMED tool to 198 participants on routine visits to households. Consenting family members provided basic biographical information prior to the administration of the tool. To determine the accuracy of the CMED in identifying individuals in households with possible mental health disorders, we compared the number of individuals identified using the CMED vignettes to the validated Brief Mental Health (BMH) screening tool.
The CMED performed at an acceptable level with an area under the curve (AUC) of 0.73 (95% CI 0.67-0.79), identifying 79% (sensitivity) of participants as having a possible mental health problem and 67% (specificity) of participants as not having a mental health problem. Overall, the CMED positively identified 55.2% of household members relative to 49.5% on the BMH.
The CMED is acceptable as a mental health screening tool for use by CHWs at a household level.
心理健康障碍筛查工具可提高初级卫生保健（PHC）层面的疾病检出率。然而，许多有心理健康问题的人由于缺乏心理健康知识、对精神疾病存在污名化观念以及对初级卫生保健机构提供的心理健康服务缺乏认知，而不去寻求治疗。因此，在社区层面开展提高心理健康意识并改善心理健康状况检测的干预措施，对于增加需求和优化现有心理健康服务的供给至关重要。本研究旨在评估社区心理健康教育与检测（CMED）工具使用图片 vignettes 识别心理健康状况的准确性。
社区卫生工作者（CHWs）在对198名参与者进行常规家访时使用CMED工具。在使用该工具之前，同意参与的家庭成员提供了基本的个人信息。为了确定CMED在识别家庭中可能存在心理健康障碍个体方面的准确性，我们将使用CMED vignettes识别出的个体数量与经过验证的简易心理健康（BMH）筛查工具进行了比较。
CMED的表现处于可接受水平，曲线下面积（AUC）为0.73（95%CI 0.67 - 0.79），将79%（敏感性）的参与者识别为可能存在心理健康问题，67%（特异性）的参与者识别为不存在心理健康问题。总体而言，相对于BMH识别出的49.5%，CMED正确识别出了55.2%的家庭成员。
CMED作为一种心理健康筛查工具，可供社区卫生工作者在家庭层面使用，是可接受的。
