Abstract
Orientation: South Africa carries a high burden of mental ill-health. Screening to identify individuals for further referral is emerging as one pathway to promote access to mental health interventions. Existing occupational health surveillance infrastructure may be a useful mechanism for clinical mental health screening. Research purpose: This study explored the clinical validity of a range of brief mental health measures in the context of occupational health surveillance. Motivation for the study: To meaningfully screen for mental health as part of occupational health surveillance, tools are required that are empirically validated, clinically useful, locally available and practical to administer. Research approach/design and method: Workers ( n = 1816), recruited through workplace occupational health surveillance programmes, completed the Patient Health Questionnaire-9, Brief Symptom Inventory 18-somatisation subscale, Generalised Anxiety Disorder scale-7, Primary Care Post-Traumatic Stress Disorder Screen, Intense (panic-like) anxiety scale and CAGE scale and partook in a diagnostic interview with a clinical psychologist. Main findings: Basic psychometric characteristics were reported, including confirmatory factor analyses, measurement invariance, internal consistencies and socio-demographic effects. Clinical utility was explored through receiver operating/operator characteristics curve analyses, and calculations of positive and negative predictive values, as well as sensitivity and specificity. These indicators provided evidence of clinical validity in the study context. Practical/managerial implications: The findings support the use of psychological screening as a brief, practicable and easily accessible mode of occupational mental health support. Contribution/value-add: This article presented evidence of structural and criterion validity for these scales and described their clinical application for practical use in occupational mental health surveillance.
Highlights
OrientationThe provision of mental health services in South Africa (SA) faces serious challenges, in part because of severe resource constraints (Docrat, Besada, Cleary, Daviaud, & Lund, 2019)
Research purpose: This study explored the clinical validity of a range of brief mental health measures in the context of occupational health surveillance
receiver operating/ operator characteristics (ROC), receiver operating/operator characteristic; AUC, area under the curve; 95% CI, 95% confidence interval; PPV, positive predictive value; NPV, negative predictive value; SENS, sensitivity; SPEC, specificity; SA, South Africa; HIV, human immunodeficiency virus; GAD, Generalised Anxiety Disorder; PTSD, post-traumatic stress disorder; DSM, Diagnostic and statistical manual of mental disorders (5th ed.)
Summary
The provision of mental health services in South Africa (SA) faces serious challenges, in part because of severe resource constraints (Docrat, Besada, Cleary, Daviaud, & Lund, 2019). It is in addressing the gap between the mental health needs and the availability of providers that screening, with the aim of identifying individuals for further referral or support, has emerged as one pathway to promote access to individuals who require mental health interventions. This study set out to explore the clinical validity of a set of brief mental health measures in the specific context of occupational health surveillance initiatives.
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