NR 505 Week 5 Research Summary

In adolescents and young adults aged 15-25 years of age in a primary care setting, what is the effect of routine mental health screening compared to no screening on diagnosis and treatment of mental health conditions over 12 months after initiation of the intervention?

QUANTITATIVE STUDIES(use these headers for EACH quantitative study):

Author/Title/Year (APA format):Bentley, K. H., Sauer-Zavala, S., Stevens, K. T., & Washburn, J. J. (2020). Implementing an evidence-based psychological intervention for suicidal thoughts and behaviors on an inpatient unit: Process, challenges, and initial findings. General Hospital Psychiatry, 63, 76–82. https://doi.org/10.1016/j.genhosppsych.2018.09.012

Problem related to PICOT: challenges in the implementation of evidence-based psychological treatments for suicidal thoughts and behaviors among patients suffering from mental health problems.

Purpose: The purpose of this study was to describe the effectiveness of a Unified Protocol for Transdiagnostic Treatment of Emotional Disorders (UP).

Sample/Population: the sample comprised 194 patients with suicidal thoughts and behaviors alongside affective disorders.

Data Collection Method: Descriptive and outcome data were obtained and stored during the admission or discharge of the patients. Questionnaires were used to obtain relevant data, including that related to suicidal thoughts or attempts by the participants.

Major Findings/Conclusions: The program, which incorporated regular screening of the patients for suicidal risks improved suicidal ideation, depression, emotion regulation, and anxiety symptoms among the participants. The intervention had a high acceptability rate.

Contribution to Review of the Literature: The article shows that interventions that incorporate patient screening for risks of mental health problems such as suicidality are effective.

Author/Title/Year (APA format): Bahraini, N., Reis, D. J., Matarazzo, B. B., Hostetter, T., Wade, C., & Brenner, L. A. (2022). Mental health follow-up and treatment engagement following suicide risk screening in the Veterans Health Administration. PLOS ONE, 17(3), e0265474. https://doi.org/10.1371/journal.pone.0265474

Problem related to PICOT: the lack of understanding about the effect of interventions such as screening and follow-up on mental health treatment outcomes among patients with suicidal behaviors.

Purpose: the purpose of the study was to evaluate mental treatment engagement and follow-up in the Veterans Health Administration following the administration of the Columbia-Suicide Severity Rating Scale Screen.

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Sample/Population: 97224 veterans

Data Collection Method: Data was extracted from the VA Corporate Data Warehouse. The extracted data included data is hospital visits, follow-up, engagement, demographic data, and mental health diagnosis.

Major Findings/Conclusions: Population-level screening is an effective tool to identify suicide risk and increase mental health engagement and follow-up. Institution should have comprehensive and standardized risk screening programs for mental health problems such as depression and suicidality.

Contribution to Review of the Literature: The article supports the provision of screening services to improve treatment outcomes among patients suffering from mental illnesses.

Author/Title/Year (APA format): Pfoh, E. R., Janmey, I., Anand, A., Martinez, K. A., Katzan, I., & Rothberg, M. B. (2020). The Impact of Systematic Depression Screening in Primary Care on Depression Identification and Treatment in a Large Health Care System: A Cohort Study. Journal of General Internal Medicine, 35(11), 3141–3147. https://doi.org/10.1007/s11606-020-05856-5

Problem related to PICOT: the lack of evidence on the effectiveness of systematic depression screening on timely treatment, care outcomes, and quality measures.

Purpose: the purpose of this study was to examine the impact of integrating systematic depression screening with clinical decision support on the diagnosis and treatment of depression.

Sample/Population: 259411 patients.

Data Collection Method: Electronic health records was used to identify and extract patient data such as clinical, demographic and utilization data.

Major Findings/Conclusions: the use of the systematic depression screening increased the percentage of patients diagnosed with depression and initiated on treatment. There was an increase in the percentage of patients receiving treatment within 90 days from 64% before the implementation to 69% after the implementation.

Contribution to Review of the Literature: the study supports the provision of mental health screening services to facilitate increased diagnosis and treatment.

Author/Title/Year (APA format): Randle, A. C., Spurlock, A. L., & Kelley, S. (2019). Depression Screening Among African American Adults in the Primary Care Setting. Journal of Psychosocial Nursing and Mental Health Services, 57(10), 18–23. https://doi.org/10.3928/02793695-20190610-01

Problem related to PICOT: The undiagnosed and misdiagnosed major depression among the African American communities, which lead to poor outcomes.

Purpose: The purpose of this study was to examine the effects of a depression screening tool on depression diagnoses and treatment.

Sample/Population: 200 patients

Data Collection Method: Data about their clinical status, demographic, and depression levels were obtained before and after the use of the screening tool.

Major Findings/Conclusions: No patient out of the 200 was diagnosed with depression before the use of the depression screening tool. The implementation of the tool led to 75 patients out of 182 being diagnosed with depression.

Contribution to Review of the Literature: the article supports the implementation of systematic screening programs for mental health problems for timely diagnosis and treatment.

Author/Title/Year (APA format): Lean, M., Fornells-Ambrojo, M., Milton, A., Lloyd-Evans, B., Harrison-Stewart, B., Yesufu-Udechuku, A., Kendall, T., & Johnson, S. (2019). Self-management interventions for people with severe mental illness: Systematic review and meta-analysis. The British Journal of Psychiatry, 214(5), 260–268. https://doi.org/10.1192/bjp.2019.54

Problem related to PICOT: The inadequate evidence about the effectiveness of self-management interventions, including the increased utilization of screening services for major depression.

Purpose: the purpose of the study was to evaluate the effectiveness of self-management interventions for adults suffering from mental health problems.

Sample/Population: 37 studies that met the inclusion criteria

Data Collection Method: data was extracted symptoms change, improved functioning, length of admission, and self-efficacy.

Major Findings/Conclusions: The incorporation of self-management interventions into mental health improved mental health outcomes. Improved self-efficacy increase the utilization of care services such as screening among patients with mental health problems.

Contribution to Review of the Literature: the article shows that screening services encourage the patient to be actively involved in the optimum management of their mental health problems.

Author/Title/Year (APA format): Lindow, J. C., Hughes, J. L., South, C., Minhajuddin, A., Gutierrez, L., Bannister, E., Trivedi, M. H., & Byerly, M. J. (2020). The Youth Aware of Mental Health Intervention: Impact on Help Seeking, Mental Health Knowledge, and Stigma in U.S. Adolescents. Journal of Adolescent Health, 67(1), 101–107. https://doi.org/10.1016/j.jadohealth.2020.01.006

Problem related to PICOT: The lack of evidence on the effectiveness of the Youth Aware of Mental Health (YAM), which encourages youth to be aware of their mental health needs and utilize health promotion services, including screening.

Purpose: the purpose of the study was to document the potential for YAM to reduce suicidal attempt, ideation, and suicide.

Sample/Population: the sample was 1878 students in 11 schools

Data Collection Method: Questionnaires to obtain information on intent to seek help, help seeking behavior and mental illness stigma were used for data collection.

Major Findings/Conclusions: there were improvements in help seeking behavior, mental health literacy, and decreased mental health-related stigma.

Contribution to Review of the Literature: Implementing population-centered programs such as YAM raise awareness about the utilization of mental health interventions, including screening services. Increased screening uptake ensures timely diagnosis and treatment of mental health problems.

Author/Title/Year (APA format): Lustig, S., Kaess, M., Schnyder, N., Michel, C., Brunner, R., Tubiana, A., Kahn, J.-P., Sarchiapone, M., Hoven, C. W., Barzilay, S., Apter, A., Balazs, J., Bobes, J., Saiz, P. A., Cozman, D., Cotter, P., Kereszteny, A., Podlogar, T., Postuvan, V., … Wasserman, D. (2022). The impact of school-based screening on service use in adolescents at risk for mental health problems and risk-behaviour. European Child & Adolescent Psychiatry. https://doi.org/10.1007/s00787-022-01990-z

Problem related to PICOT: the low uptake of screening services for mental health problems among the adolescents.

Purpose: The purpose of this study was to assess the impact of school-based screening on service utilization among adults at risk for risk-behavior and mental health problems.

Sample/Population: 4172 students

Data Collection Method: Clinical interview was conducted with the study participants. Questionnaire were also administered.

Major Findings/Conclusions: School-based screening programs for mental health problems are effective for early diagnosis and treatment of mental health problems. They also increase the uptake and utilization of mental health services among the youth and adolescents.

Contribution to Review of the Literature: The study shows the need for the provision of school-based screening services besides that offered in clinical settings to increase the diagnosis and treatment rate for mental health problems.

Author/Title/Year (APA format): Low, D. M., Bentley, K. H., & Ghosh, S. S. (2020). Automated assessment of psychiatric disorders using speech: A systematic review. Laryngoscope Investigative Otolaryngology, 5(1), 96–116. https://doi.org/10.1002/lio2.354

Problem related to PICOT: The limited access to mental health screening services for most of the Americans and the benefit of incorporating technology into mental health assessment.

Purpose: the purpose of the study was to evaluate the impact of automated assessment of psychiatric disorders using speech.

Sample/Population: the authors used 127 studies that met the inclusion criteria.

Data Collection Method: the data on sample size, speech eliciting tasks, clinical evaluation method, machine learning methodology and performance were extracted from the included studies.

Major Findings/Conclusions: the incorporation of automated screening for mental health disorders is effective. Speech processing technology may help healthcare providers in screening, diagnosing and initiating early treatments for mental health problem.

Contribution to Review of the Literature: The article demonstrates the potentials of incorporating technology into the screening of patients for mental health problems. Technologies ensure safety, quality, and efficiency in mental healthcare.

QUALITATIVE STUDIES (use these headers for EACH qualitative study):

Author/Title/Year (APA format):Richards, J. E., Hohl, S. D., Whiteside, U., Ludman, E. J., Grossman, D. C., Simon, G. E., Shortreed, S. M., Lee, A. K., Parrish, R., Shea, M., Caldeiro, R. M., Penfold, R. B., & Williams, E. C. (2019). If You Listen, I Will Talk: The Experience of Being Asked About Suicidality During Routine Primary Care. Journal of General Internal Medicine, 34(10), 2075–2082. https://doi.org/10.1007/s11606-019-05136-x

Problem related to PICOT: The lack of understanding of the patient experiences with the use of depression screening instruments and suicide risk assessment during their routine clinical visits.

Purpose: the purpose of the study was to explore the experiences of the patients with the routine population-based depression screening/assessment followed by suicide assessment and discussion with the healthcare providers.

Sample: 37 patients from Kaiser Permanente Washington

Data Collection Method: Structured interviews by phone were conducted. The data was recorded and transcribed. Conventional and directive knowledge were used in applying knowledge from previous studies and elucidate new information for the study.

Key Findings/Themes:the identified themes include participants considering suicidality as contextually appropriate, existence of mismatch between their lived experiences and PHQ-9 ninth question, suicidality disclosures involving weighing hope for help against fears, and provider relationship and acts of caring and listening being crucial. Routine screen for suicidality was also identified to contribute to positive treatment experiences.

Contribution to Review of the Literature: The study shows that healthcare providers embrace responsive interventions to prevent suicidality by administering suicide and depression screening tests at any of their patient encounters.

META-ANALYSIS STUDIES (use these headers for EACH meta-analysis study):

Author/Title/Year (APA format):Doupnik, S. K., Rudd, B., Schmutte, T., Worsley, D., Bowden, C. F., McCarthy, E., Eggan, E., Bridge, J. A., & Marcus, S. C. (2020). Association of Suicide Prevention Interventions With Subsequent Suicide Attempts, Linkage to Follow-up Care, and Depression Symptoms for Acute Care Settings: A Systematic Review and Meta-analysis. JAMA Psychiatry, 77(10), 1021–1030. https://doi.org/10.1001/jamapsychiatry.2020.1586

Problem related to PICOT:Lack of evidence about the effectiveness of suicide prevention interventions such as regular screening on subsequent suicide attempts, depression symptoms, and linkage to follow-up care.

Purpose:the purpose of this study was to examine the association of brief acute care suicide prevention interventions with patients’ subsequent suicide attempts, linkage to follow-up, and depression symptoms during follow-up.

Search selection method: A search for relevant sources of data was done on databases that included CINAHL, Scopus, MEDLINE, Ovid, Embase, PsychINFO, and references of the studies selected for the analysis.

Meta-Analysis Model:The researchers used the PRISMA guidelines and Cochrane Risk of Bias tool.

Consistency/Variation of Studies:The included studies must have met the developed inclusion criteria.

Summary of Findings: 14 studies were included in the review. Pooled-effect estimates showed that suicide prevention interventions, including screening patients for risks ere effect in reducing suicide attempts and increased linkage to follow-up. The interventions did not reduce depression symptoms.

NR 505 Week 5 Research Summary References

Bahraini, N., Reis, D. J., Matarazzo, B. B., Hostetter, T., Wade, C., & Brenner, L. A. (2022). Mental health follow-up and treatment engagement following suicide risk screening in the Veterans Health Administration. PLOS ONE, 17(3), e0265474. https://doi.org/10.1371/journal.pone.0265474

Bentley, K. H., Sauer-Zavala, S., Stevens, K. T., & Washburn, J. J. (2020). Implementing an evidence-based psychological intervention for suicidal thoughts and behaviors on an inpatient unit: Process, challenges, and initial findings. General Hospital Psychiatry, 63, 76–82. https://doi.org/10.1016/j.genhosppsych.2018.09.012

Doupnik, S. K., Rudd, B., Schmutte, T., Worsley, D., Bowden, C. F., McCarthy, E., Eggan, E., Bridge, J. A., & Marcus, S. C. (2020). Association of Suicide Prevention Interventions With Subsequent Suicide Attempts, Linkage to Follow-up Care, and Depression Symptoms for Acute Care Settings: A Systematic Review and Meta-analysis. JAMA Psychiatry, 77(10), 1021–1030. https://doi.org/10.1001/jamapsychiatry.2020.1586

Lean, M., Fornells-Ambrojo, M., Milton, A., Lloyd-Evans, B., Harrison-Stewart, B., Yesufu-Udechuku, A., Kendall, T., & Johnson, S. (2019). Self-management interventions for people with severe mental illness: Systematic review and meta-analysis. The British Journal of Psychiatry, 214(5), 260–268. https://doi.org/10.1192/bjp.2019.54

Lindow, J. C., Hughes, J. L., South, C., Minhajuddin, A., Gutierrez, L., Bannister, E., Trivedi, M. H., & Byerly, M. J. (2020). The Youth Aware of Mental Health Intervention: Impact on Help Seeking, Mental Health Knowledge, and Stigma in U.S. Adolescents. Journal of Adolescent Health, 67(1), 101–107. https://doi.org/10.1016/j.jadohealth.2020.01.006

Low, D. M., Bentley, K. H., & Ghosh, S. S. (2020). Automated assessment of psychiatric disorders using speech: A systematic review. Laryngoscope Investigative Otolaryngology, 5(1), 96–116. https://doi.org/10.1002/lio2.354

Lustig, S., Kaess, M., Schnyder, N., Michel, C., Brunner, R., Tubiana, A., Kahn, J.-P., Sarchiapone, M., Hoven, C. W., Barzilay, S., Apter, A., Balazs, J., Bobes, J., Saiz, P. A., Cozman, D., Cotter, P., Kereszteny, A., Podlogar, T., Postuvan, V., … Wasserman, D. (2022). The impact of school-based screening on service use in adolescents at risk for mental health problems and risk-behaviour. European Child & Adolescent Psychiatry. https://doi.org/10.1007/s00787-022-01990-z

Pfoh, E. R., Janmey, I., Anand, A., Martinez, K. A., Katzan, I., & Rothberg, M. B. (2020). The Impact of Systematic Depression Screening in Primary Care on Depression Identification and Treatment in a Large Health Care System: A Cohort Study. Journal of General Internal Medicine, 35(11), 3141–3147. https://doi.org/10.1007/s11606-020-05856-5

Randle, A. C., Spurlock, A. L., & Kelley, S. (2019). Depression Screening Among African American Adults in the Primary Care Setting. Journal of Psychosocial Nursing and Mental Health Services, 57(10), 18–23. https://doi.org/10.3928/02793695-20190610-01

Richards, J. E., Hohl, S. D., Whiteside, U., Ludman, E. J., Grossman, D. C., Simon, G. E., Shortreed, S. M., Lee, A. K., Parrish, R., Shea, M., Caldeiro, R. M., Penfold, R. B., & Williams, E. C. (2019). If You Listen, I Will Talk: The Experience of Being Asked About Suicidality During Routine Primary Care. Journal of General Internal Medicine, 34(10), 2075–2082. https://doi.org/10.1007/s11606-019-05136-x

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