A screening instrument for mental illness in black patients in primary health care settings

[摘要] English: Mental illness is to an alarming extent undetected among black people andspecifically in the Primary Health Care (PHC) setting. The main reason for thisis that black people with mental health needs present with somatic symptoms.This results in unnecessary tests and inappropriate treatment.Although there is an instrument (Self Reporting Questionnaire) that wasspecifically designed to detect mental illness in the PHC setting, literatureindicates some concerns in the usage of this instrument.This study is the development of a screening instrument to detect mentalillness among black people in the PHC. A non-experimental design whichexplored, described, developed and assessed was used in the developmentof the instrument. Several research techniques were used to obtain theinformation on which the instrument was based, i.e. a literature survey, focusgroup interview, patient record audit and the Delphi technique. Thereafter theinstrument was subjected to a clinical assessment. The instrument consists of two parts. Part I is very brief with the objective ofidentifying the need for further screening. Part II is longer and aims to identifythe presence of mental illness.The clinical assessment of the instrument resulted in a sensitivity of 79% anda specificity 70%. These results are very promising especially whenconsidering that some of the problems of the SRQ seem to be counteracted.Furthermore this is an instrument that has been developed at grass rootslevel.To enhance the value of the instrument the following recommendations weremade. The instrument should be assessed in a broader geographical area aswell as the specific time it took to implement. This may act as additionalmotivation for a wider application of the instrument.

[发布机构] University of the Free State