ENHANCING MENTAL HEALTH SCREENING IN FAMILY MEDICINE

Hanan Husam Hashim*, Suha Salim Issa Al-Dulaimi and Ruaa Ghanim Khaleel

ABSTRACT

Background: Mental health disorders are common in primary care settings and contribute to high levels of disability, mortality, and healthcare costs. Despite awareness efforts, underdiagnosis remains a persistent issue. The Problem-Oriented Patient Report (POPR) was introduced as a screening tool to enhance the detection of mental health conditions in primary care. Methods: This study was conducted in two primary care clinics with different administrative structures. The POPR, a self-reported checklist covering physical and mental symptoms, was administered to patients while waiting for their appointments. Physicians reviewed the completed forms, and patient charts were analyzed to assess existing and newly diagnosed mental health conditions. Data were statistically evaluated using SPSS to compare diagnostic rates and patient characteristics across clinics. Results: A total of 1,055 patients were approached, with significantly higher participation at the independent clinic (91.4%) compared to the hospital-affiliated clinic (37.1%). Physicians at both clinics documented very few new mental health diagnoses despite the identification of potential cases by the POPR. Depression and anxiety were the most frequently flagged conditions, yet 64% to 95% of patients with these symptoms remained undiagnosed. Physician engagement with the screening tool was limited, and additional training did not significantly improve diagnostic rates. Conclusion: Despite its ease of use, the POPR did not significantly increase the detection of mental illnesses in primary care. Structural and attitudinal barriers among physicians, along with competing clinical demands, contributed to the low utilization of the tool. Future interventions should explore multifaceted strategies, including improved physician training, workflow integration, and patient advocacy, to enhance mental health screening in primary care.

Keywords: Despite awareness efforts, underdiagnosis remains a persistent issue