Casting a wider net in behavioral health screening in primary care: a preliminary study of the Outcome Rating Scale

• Published in: Primary health care research & development 2017-03, Vol.18 (2), p.188-193
• Main Authors: DeSantis, Brian, Jackson, Miranda J., Duncan, Barry L., Reese, Robert J.
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Drug abuse; Female; Humans; Internal medicine; Male; Mass Screening - methods; Medical screening; Medicine; Mental depression; Mental disorders; Mental Disorders - diagnosis; Mental health; Mental Health Services - organization & administration; Middle Aged; Patients; Primary care; Primary Health Care - organization & administration; Psychotherapy; Questionnaires; Short Report; Studies; Substance abuse treatment; Surveys and Questionnaires; Task forces; Validity
• ISSN: 1463-4236; 1477-1128
• DOI: 10.1017/S1463423616000311

Introduction The integration of behavioral health services into primary care has led to enhanced use of brief screening measures to identify mental health problems. Although useful, such instruments are largely symptom based and diagnosis specific. This narrow focus can potentially limit the identification of broader social or relational distress in patients that affect medical outcomes, as well as present feasibility challenges using a multi-measure approach in identifying mental health comorbidities. This exploratory study of adult primary care patients compared an ultra-brief, and widely used measure of global distress across life functioning, the Outcome Rating Scale (ORS), with the Patient Health Questionnaire (PHQ-9 and PHQ-2). Correlations between the ORS and the PHQ-9 and PHQ-2 indicated agreement between the measures in classifying patients, and the ORS identified significantly more patients in the clinical range. Discussion Although results are preliminary, the ORS may cast a wider net in identifying patients with significant distress in primary care.