Development of a brief mental health screen for intimate partner violence victims in the emergency department.
BACKGROUND
Emergency physicians routinely treat victims of intimate partner violence (IPV) and patients with mental health symptoms, although these issues may be missed without routine screening. In addition, research has demonstrated a strong association between IPV victimization and mental health symptoms.


OBJECTIVE
To develop a brief mental health screen that could be used feasibly in an emergency department to screen IPV victims for depressive symptoms, posttraumatic stress disorder (PTSD) symptoms, and suicidal ideation.


METHODS
The authors conducted a pretest/posttest validation study of female IPV victims to determine what questions from the Beck Depression Inventory II, Posttraumatic Stress Diagnostic Scale, and Beck Scale for Suicide Ideation would predict moderate to severe levels of depressive symptoms, PTSD symptoms, and suicidal ideation. A principal components factor analysis was conducted to determine which questions would be used in the brief mental health screen. Scatter plots were then created to determine a cut point.


RESULTS
Scores on the brief mental health screen ranged from 0 to 8. A cutoff score of 4 was used, which resulted in positive predictive values of 96% for the brief mental health screen for depression, 84% for PTSD symptoms, and 54% for suicidal ideation. In particular, four questions about sadness, experiencing a traumatic event, the desire to live, and the desire to commit suicide were associated with moderate to severe mental health symptoms in IPV victims.


CONCLUSIONS
The brief mental health screen provides a tool that could be used in an emergency department setting and predicted those IPV victims with moderate to severe mental health symptoms. Using this tool can assist emergency physicians in recognizing at-risk patients and referring these IPV victims to mental health services.
Houry
Debra
D
Department of Emergency Medicine, Emory University, Atlanta, GA, USA. dhoury@emory.edu
Kemball
Robin S
RS
Click
Lorie A
LA
Kaslow
Nadine J
NJ
D000293:Adolescent; D000328:Adult; D003863:Depression / Q000175:diagnosis / Q000209:etiology; D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans; D007406:Interview, Psychological / Q000379:methods*; D008403:Mass Screening / Q000379:methods*; D008875:Middle Aged; D011237:Predictive Value of Tests; D025341:Principal Component Analysis; D013179:Spouse Abuse / Q000517:prevention & control* / Q000523:psychology*; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis / Q000209:etiology; D013405:Suicide / Q000523:psychology; D000092864:Suicide Prevention