ABSTRACT
BACKGROUND: The Global Mental Health Assessment Tool-Primary Care Version (GMHAT/PC) has been developed to assist health professionals to make a quick and comprehensive standardised mental health assessment. It has proved to be a reliable and valid tool in a previous study involving GPs. Its use by other health professionals may help in detecting and managing mental disorders in primary care and general health settings. AIM: To assess the feasibility of using a computer-assisted diagnostic interview by nurses and to examine the level of agreement between the GMHAT/PC diagnosis and psychiatrists' clinical diagnosis. DESIGN OF STUDY: Cross-sectional validation study. SETTING: Primary care, general healthcare (cardiac rehabilitation clinic), and community mental healthcare settings. METHOD: A total of 215 patients between the ages of 16 and 75 years were assessed by nurses and psychiatrists in various settings: primary care centre (n = 54), cardiac rehabilitation centre (n = 98), and community mental health clinic (n = 63). The time taken for the interview, and feedback from patients and interviewers were indicators of feasibility, and the kappa coefficient (kappa), sensitivity, and specificity of the GMHAT/PC diagnosis were measures of validity. RESULTS: Mean duration of interview was under 15 minutes. The agreement between nurses' GMHAT/PC interview-based diagnosis and psychiatrists' International Classification of Diseases (ICD)-10 criteria-based clinical diagnosis was 80% (kappa = 0.76, sensitivity = 0.84, specificity = 0.92). CONCLUSION: The GMHAT/PC can assist nurses to make accurate mental health assessment and diagnosis in various healthcare settings and it is acceptable to patients.
Subject(s)
Diagnosis, Computer-Assisted/nursing , Mental Disorders/diagnosis , Psychiatric Status Rating Scales/standards , Adolescent , Adult , Aged , Community Mental Health Services , Cross-Sectional Studies , Family Practice , Feasibility Studies , Female , Humans , Male , Mental Disorders/nursing , Middle Aged , Sensitivity and SpecificityABSTRACT
The Global Mental Health Assessment Tool--Primary Care Version (GMHAT/PC) is a computerised clinical assessment tool developed to assess and identify a wide range of mental health problems in primary care. It generates a computer diagnosis, a symptom rating, a self-harm risk assessment, and a referral letter. Patients from primary care and community psychiatric outpatient clinics and a small sample of inpatients were interviewed for a period of two months using the GMHAT/PC. A proportion of patients were simultaneously rated by a psychiatrist and a general practitioner for inter-rater reliability. All patients also completed the Hospital Anxiety and Depression Scale (HAD). To conduct the interview was easy in all settings and took 10-15 minutes for patients who had psychiatric symptoms. Inter-rater agreement on mental state symptom groups ranged from 0.49 to 1 (kappa). The computer diagnosis correlated highly with the clinical diagnosis and there was a good level of agreement between HAD ratings and GMHAT/PC ratings. These data suggest that the GMHAT/PC is an easy to administer computerised tool which can be used in primary care for the standardised assessment of mental health problems.
