Behavioral Health Screening Tools

Transcription

1 Behavioral Health Screening Tools

2 LEARNING OBJECTIVES 1. Practice seven evidence-based behavioral health (BH) screening tools: PHQ-2, PHQ- 9, Edinburg, GAD, OASIS, Vanderbilt and CAGE-AID. 2. Demonstrate how screening tool results determine the BH referral process. 3. Identify at least two benefits of BH case management programs to support patient care. 2

3 WHAT ARE SCREENING TOOLS Efficient questionnaires that are completed by the member Easy to administer with no requirement of specialized training Yield quick results Screening tools are not psychological tests. For questions related to billing services following a screening, please read the Medical Policy for Psychological Testing located at ExcellusBCBS.com/ProviderMedicalPolicies. 3

4 WHY USE SCREENING TOOLS? Early identification Earlier access to treatment Improved treatment out comes Reduced costs 4

5 SEVEN BH SCREENING TOOLS Depression Anxiety ADHD Alcohol & Substance Use PHQ-2 GAD Vanderbilt CAGE-AID PHQ-9 OASIS Edinburg The PHQ and GAD-7 screeners and translations are available at: No permission is required to reproduce, translate, display or distribute them. 5

6 PHQ-2 DEPRESSION SCREENING TOOL How often have you been bothered by any of the following OVER THE LAST TWO WEEKS: Little interest or pleasure in doing things? Feeling down, depressed or hopeless? NOT to diagnose or monitor depression severity. Scores: If score 3... further evaluation needed. Do PHQ-9 to determine if criteria met for depressive disorder. 6

7 PHQ-9 DEPRESSION SCREENING TOOL 7

8 PHQ-9 DEPRESSION SCREENING TOOL Let s do a screening! Pat is a 54 year old female. Her chief complaints are: Trouble sleeping 2x/week Has been late to work 3x for oversleeping in the last two weeks Eats at night when unable to sleep Low energy for the last month 8

9 PHQ-9 SCORES & PROPOSED TREATMENT 9

10 EDINBURG DEPRESSION SCREENING TOOL What is the most common complication of childbearing? Untreated antenatal depression: Associated with smaller head circumference Lower Apgar scores Higher cortisol levels at birth Alteration in heart rate variability Increased admissions to neonatal care units 10

11 EDINBURG DEPRESSION SCREENING TOOL 11

12 EDINBURG DEPRESSION SCREENING TOOL For use with pregnant or postpartum patients Consists of 10 questions Assesses how patient has been feeling over the past seven days Will not detect mothers with anxiety neuroses, phobias or personality disorders 12

13 GAD ANXIETY SCREENING TOOL 13

14 GAD ANXIETY SCREENING TOOL Addresses seven different symptoms consistent with GAD Score of: 0-5 Mild anxiety 6-10 Moderate anxiety Moderately severe anxiety Severe anxiety 14

15 OASIS ANXIETY RATING SCALE 15

16 ADHD - NICHQ VANDERBILT 16

17 CAGE-AID ALCOHOL & SUBSTANCE USE SCREENING TOOL 17

18 REFERRALS & SUPPORT SERVICES To community mental health providers: Licensed psychiatrists, psychologists and therapists To case management: Intensive case management 18

19 INTENSIVE CASE MANAGEMENT Who do they engage with? What is the benefit to patients? What is the benefit to providers? Treatment focus: day case length Managing symptoms through non-er behavioral health treatment Co-occurring conditions 19

20 REFERRALS TO CASE MANAGEMENT Patient Calls toll-free Customer Care number Customer Care Asks for behavioral health Tells the representative what his/her behavioral health needs are Makes referral for Case Management BH Case Management Outreach to member within 48 business hours of receiving referral from Customer Care 20

21 SCREENING TOOL RESOURCES The American Academy of Pediatrics has listing of mental health screening and assessment tools: Summarizes psychometric testing properties, cultural considerations, costs and key references Includes proprietary and free products Website: References American Psychological Association: Field T, Diego M, Hernandez-Reif M, Schanberg S, Kuhn C, Yando R, Bendell D. Pregnancy anxiety and comorbid depression and anger: effects on the fetus and neonate. Depress Anxiety. 2003;17: Sjostrom K, Valentin L, Thelin T, Marsal K. Maternal anxiety in late pregnancy: effect on fetal movements and fetal heart rate. Early Hum Dev. 2002;67: Zax M, Sameroff AJ, Babigian HM. Birth outcomes in the offspring of mentally disordered women. Am J Orthopsychiatry. 1977;47:

22 QUESTIONS? 22