Mental health diagnosis by nurses using the Global Mental Health Assessment Tool: A validity and feasibility study

Abstract

Background: The Global Mental Health Assessment Tool - Primary Care Version (GMHAT/PC) has been developed to assist health professionals to make a quick and comprehensive standardised mental health assessment. It has proved to be a reliable and valid tool in a previous study involving GPs. Its use by other health professionals may help in detecting and managing mental disorders in primary care and general health settings. Aim: To assess the feasibility of using a computer-assisted diagnostic interview by nurses and to examine the level of agreement between the GMHAT/PC diagnosis and psychiatrists' clinical diagnosis. Design of study: Cross-sectional validation study. Setting: Primary care, general healthcare (cardiac rehabilitation clinic), and community mental healthcare settings. Method: A total of 215 patients between the ages of 16 and 75 years were assessed by nurses and psychiatrists in various settings: primary care centre (n = 54), cardiac rehabilitation centre (n = 98), and community mental health clinic (n = 63). The time taken for the interview, and feedback from patients and interviewers were indicators of feasibility, and the kappa coefficient (K), sensitivity, and specificity of the GMHAT/ PC diagnosis were measures of validity. Results: Mean duration of interview was under 15 minutes. The agreement between nurses' GMHAT/PC interview-based diagnosis and psychiatrists' International Classification of Diseases ICD)-10 criteria-based clinical diagnosis was 80% (K = 0.76, sensitivity = 0.84, specificity = 0.92). Conclusion: The GMHAT/PC can assist nurses to make accurate mental health assessment and diagnosis in various healthcare settings and it is acceptable to patients. © British Journal of Geneneral Practice.