A Proposed Brain-, Spine-, and Mental- Health Screening Methodology (NEUROSCREEN) for Healthcare Systems: Position of the Society for Brain Mapping and Therapeutics

2022 ◽  
pp. 1-21
Author(s):  
Mohammad Nami ◽  
Robert Thatcher ◽  
Nasser Kashou ◽  
Dahabada Lopes ◽  
Maria Lobo ◽  
...  

The COVID-19 pandemic has accelerated neurological, mental health disorders, and neurocognitive issues. However, there is a lack of inexpensive and efficient brain evaluation and screening systems. As a result, a considerable fraction of patients with neurocognitive or psychobehavioral predicaments either do not get timely diagnosed or fail to receive personalized treatment plans. This is especially true in the elderly populations, wherein only 16% of seniors say they receive regular cognitive evaluations. Therefore, there is a great need for development of an optimized clinical brain screening workflow methodology like what is already in existence for prostate and breast exams. Such a methodology should be designed to facilitate objective early detection and cost-effective treatment of such disorders. In this paper we have reviewed the existing clinical protocols, recent technological advances and suggested reliable clinical workflows for brain screening. Such protocols range from questionnaires and smartphone apps to multi-modality brain mapping and advanced imaging where applicable. To that end, the Society for Brain Mapping and Therapeutics (SBMT) proposes the Brain, Spine and Mental Health Screening (NEUROSCREEN) as a multi-faceted approach. Beside other assessment tools, NEUROSCREEN employs smartphone guided cognitive assessments and quantitative electroencephalography (qEEG) as well as potential genetic testing for cognitive decline risk as inexpensive and effective screening tools to facilitate objective diagnosis, monitor disease progression, and guide personalized treatment interventions. Operationalizing NEUROSCREEN is expected to result in reduced healthcare costs and improving quality of life at national and later, global scales.

2020 ◽  
Author(s):  
Nicholas C. Jacobson ◽  
Elad Yom-Tov ◽  
Damien Lekkas ◽  
Michael Heinz ◽  
Lili Liu ◽  
...  

Introduction: Most people with psychiatric illnesses do not receive treatment for almost a decade after disorder onset. Online mental health screens reflect one mechanism designed to shorten this lag in help-seeking, yet there has been limited research on the effectiveness of screening tools in naturalistic settings. Material and methods: We examined a cohort of persons directed to a mental health screening tool via the Bing search engine (n=126,060). We evaluated the impact of tool content on later searches for mental health self-references, self-diagnosis, care seeking, psychoactive medications, suicidal ideation, and suicidal intent. Website characteristics were evaluated by pairs of independent raters to ascertain screen type and content. These included the presence/absence of a suggestive diagnosis, a message on interpretability, as well as referrals to digital treatments, in-person treatments, and crisis services. Results: Using machine learning models, the results suggested that screen content predicted later searches with mental health self-references (AUC =0·73), mental health self-diagnosis (AUC = 0·69), mental health care seeking (AUC = 0·61), psychoactive medications (AUC = 0·55), suicidal ideation (AUC = 0·58), and suicidal intent (AUC = 0·60). Cox-proportional hazards models suggested individuals utilizing tools with in-person care referral were significantly more likely to subsequently search for methods to actively end their life (HR = 1·727, p = 0·007). Discussion: Online screens may influence help-seeking behavior, suicidal ideation, and suicidal intent. Websites with referrals to in-person treatments could put persons at greater risk of active suicidal intent. Further evaluation using large-scale randomized controlled trials is needed.


Iproceedings ◽  
10.2196/15207 ◽  
2019 ◽  
Vol 5 (1) ◽  
pp. e15207
Author(s):  
Dani Bradley ◽  
Christina Cobb ◽  
Adam Wolfberg

Background Roughly 11% of women suffer from postpartum depression nationwide; however, many believe the condition to be widely underreported, in part due to inadequate screening and stigma associated with the condition. Social support networks can help to prevent or mitigate symptoms related to postpartum depression. Single mothers tend to suffer from this condition at a higher rate than married women as they tend to have weaker social networks compared to married women. Objective The primary objective ws to determine whether gaps exist in mental health screening and whether digital screening tools can help to fill these gaps. The secondary objective ws to determine whether digitally delivered support proves to be more or less beneficial to subsets of women, namely based on their marital status. Methods A survey about mental health history, support, experience with mental health screeners, and characteristics of social networks was sent by email to users of the Ovia Fertility, Ovia Pregnancy, and Ovia Parenting mobile apps. Respondents were all 18 years of age or older and living in the United States. The study was granted exemption by our institutional review board. Results Of the 2016 respondents, 39% reported that they were never screened by their healthcare provider for mental health conditions (26% of women with children and 52% of women without children). Among women who reported never being screened by a healthcare provider, 17% reported that they have completed at least one of the screeners (PHQ-9 or Edinburgh Postnatal Depression Scale [EPDS]) in an Ovia mobile app. Of the 2016 respondents, 86% reported being married or in a domestic partnership. Among the single respondents, 32% reported either having children, being pregnant, or currently trying to conceive. More single women who have children, are pregnant, or are actively trying to conceive reported that they would feel most supported by a mobile appl (namely, one of Ovia Health’s three mobile apps) and to seek treatment for mental health concerns compared to married women (19% compared to 14% of married women; P=.03). Additionally, single women who have children, are pregnant, or are actively trying to conceive reported more often than married women that they feel their mental health is best supported by a mobile appl (16% compared to 10% of married women; P=.007). However, both groups of women selected their healthcare provider and their friends/family as the first and second ranking support systems for both seeking mental health treatment and for mental health related support, with the mobile app ranking last. Conclusions Screening for mental health conditions during the reproductive health journey is lacking. Digital solutions that deliver clinically validated screening tools help to screen women who are missed in a clinical setting. Women who report being single throughout parenting, pregnancy, or while trying to conceive find more value in mobile app–provided mental health support compared to married women. These findings highlight two gaps that digital technologies, like Ovia Health, can fill: low mental health screening rates during reproductive years and suboptimal social systems.


2021 ◽  
pp. 1-14
Author(s):  
Rebecca J. Bennett ◽  
Sara Donaldson ◽  
Yazdan Mansourian ◽  
Michelle Olaithe ◽  
India Kelsall-Foreman ◽  
...  

Purpose Audiology clinical guidelines recommend the use of mental health screening tools; however, they remain underutilized in clinical practice. As such, psychological concerns are frequently undetected in adults with hearing loss. This study aimed to better understand audiology clinic staff's perspectives (including audiologists, audiometrists, reception staff, and clinic managers) on how to improve detection of poor mental health by (a) exploring the role of audiology clinic staff in detecting psychological concerns in adults with hearing loss and (b) investigating the appropriateness, acceptability, and usability of several screening tools in an audiology setting. Method Eleven audiology clinic staff ( M age = 33.9 ± 7.3, range: 25–51 years) participated in a semistructured focus group. First, participants discussed the role of audiology clinic staff in detecting psychological difficulties in adults with hearing loss, including current practices and needs for improving practices. Second, participants discussed the appropriateness, acceptability, and usability of nine standardized mental health screening tools commonly used in wider health care settings. Results Audiology clinic staff described their role in being aware of, and detecting, psychological difficulties, as well as their part in promoting an understanding of the link between hearing loss and mental health. Participants described the need to provide support following detection, and highlighted barriers to fulfilling these roles. The use of mental health screening tools was considered to be client and context specific. The language used within the screener was identified as an important factor for its acceptability by audiology clinic staff. Conclusions Audiology clinic staff acknowledged that they have an important role to play in the detection of psychological difficulties and identified the core barriers to using screening tools. Future research may explore the possibility of developing a mental health screening tool specific to the unique experiences of adults with comorbid hearing loss and mental health concerns. Supplemental Material https://doi.org/10.23641/asha.16702501


2019 ◽  
Author(s):  
Aderibigbe Oluwakemi Olanike ◽  
Christopher M Perlman

AbstractBackgroundThe needs of people diagnosed with Mental Neurological and Substance-Use (MNS) conditions are complex including interactions physical, social, medical and environmental factors. Treatment requires a multidisciplinary approach including health and social services at different levels of care. However, due to inadequate assessment, services and scarcity of human resource for mental health, treatment of persons diagnosed with MNS conditions in many LMICs is mainly facility-based pharmacotherapy with minimal non-pharmacology treatments and social support services. In low resource settings, gaps in human resource capacity may be met using layperson health workers. A layperson health working is one without formal mental health training and may be equivalent to community health worker (CHW) or less cadre in primary health care system.ObjectivesThis study reviewed layperson mental health screening tools for use in supporting mental health in developing countries, including the content and psychometric properties of the tools. Based on this review this study proposes recommendations for the design and effective use of layperson mental health screening tools based on the Five Pillars of global mental health.MethodsA systematic review was used to identify and examine the use of mental health screening tools among laypersons supporting community-based mental health programs. PubMed, Scopus, CINAHL and PsychInfo databases were reviewed using a comprehensive list of keywords and MESH terms that included mental health, screening tools, lay-person, lower and middle income countries. Articles were included if they describe mental health screening tools used by laypersons for screening, delivery or monitoring of MNS conditions in community-based program in LMICs. Diagnostic tools were not included in this study. Trained research interviewers or research assistants were not considered as lay health workers for this study.ResultsThere were eleven studies retained after 633 were screened. Twelve tools were identified covering specific disorders (E.g. alcohol and substance use, subcortical dementia associated with HIV/AIDS, PTSD) or common mental disorders (mainly depression and anxiety). These tools have been tested in LMICs including South Africa, Zimbabwe, Haiti, Malaysia, Pakistan, India, Ethiopia and Brazil. The included studies show that simple screening tools can enhance the value of laypersons and better support their roles in providing community-based mental health support. However, most of the layperson MH screening tools used in LMICs do not provide comprehensive information that can inform integrated comprehensive treatment planning and understanding of the broader mental health needs of the community.ConclusionDeveloping a layperson screening tools is vital for integrated community-based mental health intervention. This study proposed a holistic framework which considers the relationship between individual’s physical, mental and spiritual aspect of mental health, interpersonal as well as broader contextual determinants (community, policy and different level of the health system) that can be consulted for developing or selecting a layperson mental health screening instrument. More research are needed to evaluate the practical application of this framework.


2021 ◽  
Vol 9 (1) ◽  
Author(s):  
Kate E. McBride ◽  
Daniel Steffens ◽  
Tim Lambert ◽  
Nick Glozier ◽  
Rachael Roberts ◽  
...  

Abstract Background Preoperative assessment of mental health rarely occurs within routine surgery. Any screening tool selected to form part of this process must be deemed practical, acceptable and valid by clinicians and consumers alike. This study aims to assess the acceptability and face validity of two existing mental health screening tools to select one for further development and use in the routine surgical setting. Methods A survey of clinicians and consumers was conducted from October 2020 to March 2021 at a tertiary hospital in Sydney, Australia. Using a Likert scale (1–5, lowest to highest rating), the clinicians evaluated four domains for acceptability and two for validity (six overall) and the consumers four domains for acceptability and one for validity (five overall) on the preoperative use of the amended Kessler Psychological Distress Scale (K10) and the Somatic and Psychological Health Report-12 (SPHERE-12). Consensus was achieved through a rating of 4 or 5 being given by 70% or more of participants with domains able to remain unchanged. Free text responses were analysed into themes. Results A total of 73 participants (51 clinicians; 22 consumers) were included. The K10 received consensus scores (≥ 70%) in four out of six domains for clinicians (4/4 acceptability; 0/2 validity), and all five domains for consumers (4/4 acceptability; 1/1 validity). The SPHERE-12 received consensus scores (≥ 70%) in three domains for clinicians (3/4 acceptability; 0/2 validity), and three domains for consumers (3/4 acceptability; 0/1 validity). Six qualitative themes were described including (1) amendments to tool structure and language; (2) scale response options; (3) difficulty with somatic questions; (4) practicality and familiarity with K10; (5) challenges for specific patient cohorts and (6) timing considerations for patients. Conclusion Adequate acceptability was established for the K10. However further development is required to strengthen its validity for this specific surgical cohort and purpose. Future research to determine the feasibility and acceptability of implementing and using the K10 in the routine surgical setting is now needed.


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