D

ORIGINAL POST- My clinical practicum setting is within a primary care o?ice, and most of
the patients I encountered are elderly patients. This demographic is at a high risk of
su?ering from mental health challenges like depression, anxiety, and deterioration of
cognitive abilities. The management of these challenges entails proper screening to allow
appropriate and timely intervention.
Therefore, mental health screening tools have practical applicability in primary care
systems. At my clinical site, the Patient Health Questionnaire-9 (PHQ-9) is employed to
identify patients with depressive disorders, and the Generalized Anxiety Disorder-7 (GAD-7)
tool to determine the anxiety level of patients. For elderly patients, the Mini Mental State
Examination (MMSE) are used to screen patients for any form of cognitive dysfunction
(American Psychiatric Association, 2022). If, for instance, there were no tools in the current
process, I would advocate for these since they are supported from research and easy to
implement in primary care settings.
From experience in my clinical assignment, most of the mental health care provision that I
have come across is extensive and their scope inclusive of comprehensive care. I have not
witnessed any direct discrimination or prejudice concerning my elderly patients’ care, but I
understand the issues concerning stigma and reluctance to address mental health issues
in the elderly. Further, the limited time available during consultation may prevent further
discussion of mental health matters.
For missed screening, I have the following two suggestions: First, the proposal of
implementing mandatory mental health screening as a part of preventive annual wellness
visits can surely help to significantly enhance the rate of detected mental health issues,
especially among high-risk groups (Rhema et al., 2020). Second, it is necessary to create
outreach programs that include mobile clinics to make it easier for individuals with limited
transportation or access to healthcare resources to receive necessary mental health
assistance, for instance, telemedicine services.
These changes, together with the continued and standard implementation of well-
validated screening instruments for mental health, may help in the early identification and
treatment of such individuals, which could eventually yield better results for high-risk
groups.

WHAT YOU ARE RESPONDING TO-
Thanks for your response to the discussion! I also work in primary care and regularly use
the PHQ and GAD tools in clinical practice. I don’t use the MMSE, but I do use the Mini-Cog
which is a similar tool. I find the PHQ to be quick and easy to use, and it has also been
shown to be both valid and reliable.

ANSWER THESE QUESTIONS: What would be your “mandatory mental health screening”?
What would you screen for? How? Are there existing evidence based USPSTF screening
recommendations for mental health screening? Why not simply use those
recommendations which are based on high level evidence?

INSTRUCTIONS- PLEASE ANSWER EACH QUESTIONS AND PROVIDED TWO APA
SCHOLARLY REFERENCE WITHIN 5 YEARS TO SUPPORT

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