While endowing doctors with their own iPads may cause unnecessary distractions — time that could be better spent looking for nonverbal cues to patients’ emotional states — giving the patients themselves the devices may do doctors some favors. A new study from King's College London has shown that waiting room assessments can screen for anxiety and depression, finding information that can then be sent straight to the patient’s doctor.
In the U.S., ailments pertaining to mental health receive far less attention than physical health. We’re quick to heal a broken bone, yet give pause at a broken brain when it’s manifested, or, more accurately, perceived, as a social disorder rather than a mental one. In that vein, depression and anxiety too often seem like things people should just “get over” or “shake.” But treating these disorders in earnest, and in combination with the physical ailments people routinely battle, can go much further in promoting overall health than treating the two on their own.
College researchers implemented a system across three London hospitals in six specialty services — rheumatology, limb reconstruction, hepatitis C, psoriasis, congenital heart disease, and chronic pain — where patients were asked to fill out a questionnaire while they sat in the waiting room. The questionnaire probed them about their mental health as it pertained to feelings of depression and anxiety. Researchers were looking primarily at the devices integrated with patients’ overall hospital experiences, but were also concerned with how the disorders matched up with the six physical ailments.
What they found was that each of the six physical maladies fell on a different part of the spectrum in terms of its relationship with depression or anxiety. Congenital heart disease, for example, was only associated with depression-like symptoms 6.6 percent of the time. Meanwhile, chronic pain sufferers showed depressive symptoms 60.9 percent of the time. Likewise, anxiety symptoms appeared according to different conditions: 11.4 percent in congenital heart disease sufferers and 25.1 percent in rheumatology patients.
Faith Matcham, a doctoral student at the Institute of Psychiatry at the College, argues this tandem approach gives physicians applicable real-time information about their patients. “It makes effective use of waiting room time,” she said in a news release. It also “provides useful, usable information in a format which is easy for non-mental health professionals to interpret and act upon."
Matcham’s point touches on the accessibility of patient information. Rather than refer patients with depressive symptoms directly to a mental health expert, without so much as glancing at the patients’ health between their ears, physicians can use the information as it relates to their own specialty. The holistic approach fuses two disciplines of health that normally walk alone. What’s more, it also signaled to researchers the importance of specialty physicians as a component of the process.
"It really highlighted to us that no two services could be handled in the same way,” Matcham commented. “Each is seeing a different type of patient, with different needs, in very different environments."
In the end, using emerging technology as a natural element of healthcare is becoming more and more common in hospitals. Doctors use iPads and other tablets for quick access of patient files and iPhones where pagers once footed the bill. Incorporating patients into that experience only serves to make an otherwise dreaded process at least somewhat more manageable. Dr. Philip R. Muskin, professor of psychiatry at Columbia University Medical Center, said the test’s presence has already boosted patient satisfaction because it touches at a core principle of care. "It engages the people who are most important, the patient and doctor, with an instrument that can tell them that something is going on."
Source: Rayner L, Matcham F, Hutton J, et al. Embedding integrated mental health assessment and management in general hospital settings: feasibility, acceptability and the prevalence of common mental disorder. General Hospital Psychiatry. 2013.