Development and assessment of a community‐based screening tool for mental health disorders among people who inject drugs

Abstract

Introduction The prevalence of mental health disorders among people who use drugs is high and well documented. This hard‐to‐reach population faces a very low awareness and access to mental health care, especially in developing countries. The objectives of this study were to design and assess a quick screening tool (QST) that community‐based organisations (CBO) could routinely apply to a Vietnamese population of people who inject drugs (PWID), in order to refer them appropriately to mental health specialists. Methods We devised a tool that included nine questions covering anxiety, depression, suicide risk and psychotic symptomatology. Its use required no specific background and 2 h training. Specificity and sensitivity of the QST were assessed in a population of 418 PWID recruited via respondent driven sampling, using the Mini International Neuropsychiatric Interview questionnaire plus clinical evaluation as a reference standard. Acceptability was assessed using a self‐administered anonymous questionnaire submitted to all CBO members who used the QST. Results CBO members considered the QST easy to use, relevant and helpful to deal with mental health issues. Area under the curve for detection of any symptom using the QST was 0.770. The maximum sensitivity and specificity were reached with a cut‐off of 2 [sensitivity was 71.1% (95% confidence interval 62.4, 78.8), specificity was 75.9% (70.5, 80.7)]. Discussion and Conclusions The QST appeared to be both efficient and well accepted. Given the burden of mental health problems among hard‐to‐reach PWID in developing countries, community‐based screenings such as this one could be a particularly appropriate response.

Gender, homelessness, hospitalization and methamphetamine use fuel depression among people who inject drugs: implications for innovative prevention and care strategies

“…A simplified psychiatric screening tool adapted to nonprofessional/ CBO members was developed as part of the DRIVE project. This 9-item questionnaire validated among PWID with acceptable psychometric characteristics and good acceptability (74,75) allows a discussion of mental health, depression, psychiatric consequences of regular drug use and their treatment with trained CBO members, particularly for PWID with multiple risk factors. Depending on the score, a consultation with a psychiatrist in situ is proposed.…”