The clinical utility of Multidimensional Behavioral Health Screen

Abstract

PurposeIn the USA, integrated care remains largely aspirational; a majority of Americans receive mental health care entirely within the primary medical care outpatient setting. A new instrument, the Multidimensional Behavioral Health Screen (MBHS) ( McCord, 2020) was developed specifically to address this gap by systematically screening for a broad array of mental health issues in every patient, every visit. The goal of this current feasibility study was to evaluate the perceptions of the primary medical care providers regarding the usefulness and practicality of the MBHS, a necessary step toward broad-based implementation.Design/methodology/approachThe MBHS was given to 101 consenting patients in a primary medical outpatient setting, each of whom was then seen by one of six participating primary care providers (PCPs). Providers completed a brief survey rating the ease of use, understandability, helpfulness and perceived accuracy of the MBHS after each patient visit and a final summary survey at the conclusion of the study.FindingsRatings were very positive overall, and the MBHS was clearly preferred to the traditional screening measures (Patient Health Questionnaire-9 [PHQ-9] and Generalized Anxiety Disorder-7 [GAD-7]). Providers offered suggestions for improvement and particularly for implementation.Research limitations/implicationsThe small sample size (101 patients and 6 PCPs) and limited geographical reach may limit generalizability. Surveying providers using similar methodology should be done with larger numbers of providers and more diverse primary medical care settings.Practical implicationsThis study provides evidence that the MBHS may be significantly effective in operationalizing the integrated care model in United States (US) healthcare systems.Social implicationsThe MBHS, a new behavioral health screening tool, was perceived by providers as useful in identifying mental health issues and guiding treatment decisions in the primary care setting.Originality/valueThis paper identifies a novel screening instrument that implements new and emerging models of psychological dysfunction in a practical way in primary medical care, making integrated care a reality rather than an aspiration.