Data reported in development and cross-validation of a veterans mental health risk factor screen

Background. VA primary care patients are routinely screened for current
symptoms of PTSD, depression, and alcohol disorders, but many who screen
positive do not engage in care. In addition to stigma about mental
disorders and a high value on autonomy, some veterans may not seek care
because of uncertainty about whether they need treatment to recover. A
screen for mental health risk could provide an alternative motivation for
patients to engage in care. Results. Twelve items assessing dissociation,
emotional lability, life stress, and moral injury correctly classified 86%
of those who later had elevated PTSD and/or depression symptoms
(sensitivity) and 75% of those whose later symptoms were not elevated
(specificity). Performance was also very good for 110 veterans who
identified as members of ethnic/racial minorities. Conclusions. Mental
health status was prospectively predicted in VA primary care patients with
high accuracy using a screen that is brief, easy to administer, score, and
interpret, and fits well into VA’s integrated primary care. When care is
readily accessible, appealing to veterans, and not perceived as
stigmatizing, information about mental health risk may result in higher
rates of engagement than information about current mental disorder status.