Mental Health Screening

On this page...
		Performance Measure
		Numerator
		Denominator
		Patient Exclusions
		Data Element
		Data Sources
		National Goals, Targets or Benchmarks for Comparison
		Outcome Measures for Consideration
		Basis for Selection and Placement in Group 2
		US Public Health Service Guidelines
		References/Notes

Percentage of new clients [ 1 ] with HIV infection who have had a mental health screening

Number of HIV-infected clients who received a mental health screening

Number of HIV-infected clients who:

• were new during the measurement year; and
• had a medical visit with a provider with prescribing privileges [ 2 ] at least once in the measurement year

None

1. Is the client HIV-infected? (Y/N)
   1. If yes, was the client new to the program during the measurement year? (Y/N)
      1. If yes, did the client receive mental health screening during the measurement year?

• Electronic Medical Record/Electronic Health Record
• CAREWare, Lab Tracker or other electronic data base
• HIVQUAL reports on this measure for grantee under review
• Medical record data abstraction by grantee of a sample of records
• Billing records

National HIVQUAL Data [ 3 ]

	2003	2004	2005	2006	2007
Top 10%	100.0%	100.0%	80.6%	86.7%	100.0%
Top 25%	93.0%	89.5%	35.1%	52.4%	84.0%
Mean*	68.2%	58.5%	21.9%	28.1%	42.0%

*from HAB data base

• Rate of mental health referrals
• Mental health-related hospitalizations
• Rate of suicide in the clinic population
• Rate of mental health disorders being treated in the clinic population

Patients living with HIV infection must often cope with multiple social, psychiatric, and medical issues. The ability to cope with these issues can dramatically impact management of the disease. The initial evaluation should include an assessment of substance abuse, economic factors, social support, mental illness and co-morbidities. [ 4 ]

The measure was placed in Group 3 because feasibility of data collection can vary considerably across grantees.

"Patients living with HIV infection must often cope with multiple social, psychiatric, and medical issues. Thus, the (initial) evaluation should also include assessment of substance abuse, economic factors, social support, mental illness, co-morbidities, and other factors that are known to impair the ability to adhere to treatment and to alter outcomes. Once evaluated, these factors should be managed accordingly." [ 5 ]

[1] "Clients" includes all clients aged 13 years or older.

[2] A "provider with prescribing privileges" is a health care professional who is certified in their jurisdiction to prescribe medications.

[3] The components of the mental health indicator were broken down and implemented for the 2005-2007 data. The Mental Health/Substance Use Subcommittee of the National HIVQUAL Clinical Advisory Committee include the following components for an annual Mental Health Screening for people with HIV: Cognitive function assessment, including mental status; Depression screening; Anxiety screening; Sleeping habits assessment; Appetite assessment; Domestic violence screening; Post Traumatic Stress Disorder screening; Psychiatric history (optional); Psychosocial assessment (optional).
(http://www.hivguidelines.org/admin/files/qoc/hivqual/proj%20info/HQNatlAggScrs3Yrs.pdf )

[4] Panel on Antiretroviral Guidelines for Adult and Adolescents. Guidelines for the Use of Antiretroviral Agents in HIV-1-Infected Adults and Adolescents. Department of Health and Human Services. January 29, 2008; 1-128. (http://aidsinfo.nih.gov/ContentFiles/AdultandAdolescentGL.pdf )

[5] Ibid.