Validation of a brief screener for broad-spectrum mental and substance-use disorders in South Africa.

Journal: Global mental health (Cambridge, England)

Volume: 11

Issue: 

Year of Publication: 

Affiliated Institutions:  Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA. Research Unit, Foundation for Professional Development, Buffalo City Metro, Eastern Cape Province, South Africa. Buffalo City Metro Health District, Eastern Cape Provincial Department of Health, Bisho, South Africa. Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York, USA. Department of Population and Family Health, Columbia University Mailman School of Public Health, New York, NY, USA. Department of Global Health, Boston University School of Public Health, Boston, MA, USA. University of North Carolina-Project, Malawi, Lilongwe, Malawi. Department of Sociomedical Sciences, Columbia University Mailman School of Public Health, New York, USA. The Desmond Tutu HIV Centre, University of Cape Town, Cape Town, South Africa. Faculty of Medicine, School of Health Systems and Public Health, University of Pretoria, Pretoria, South Africa.

Abstract summary 

In low-resource settings, valid mental health screening tools for non-specialists can be used to identify patients with psychiatric disorders in need of critical mental health care. The Mental Wellness Tool-13 (mwTool-13) is a 13-item screener for identifying adults at risk for common mental disorders (CMDs) alcohol-use disorders (AUDs), substance-use disorders (SUD), severe mental disorders (SMDs), and suicide risk (SR). The mwTool-13 is administered in two steps, specifically, only those who endorse any of the initial three questions receive the remaining ten questions. We evaluated the performance of mwTool-13 in South Africa against a diagnostic gold standard. We recruited a targeted, gender-balanced sample of adults, aged ≥18 years at primary and tertiary healthcare facilities in Eastern Cape Province. Of the 1885 participants, the prevalence of CMD, AUD, SMD, SR, and SUD was 24.4%, 9.5%, 8.1%, 6.0%, and 1.6%, respectively. The mwTool-13 yielded high sensitivities for CMD, SMD, and SR, but sub-optimal sensitivities for AUD and SUD (56.7% and 64.5%, respectively). Including a single AUD question in the initial question set improved the tool's performance in identifying AUD and SUD (sensitivity > 70%), while maintaining brevity, face-validity, and simplicity in the South African setting.

Authors & Co-authors:  Stockton Melissa Ann MA Mazinyo Ernesha Webb EW Mlanjeni Lungelwa L Nogemane Kwanda K Ngcelwane Nondumiso N Sweetland Annika C AC Basaraba Cale Neil CN Bezuidenhout Charl C Sansbury Griffin G Lovero Kathryn L KL Olivier David D Grobler Christoffel C Wall Melanie M MM Medina-Marino Andrew A Nobatyi Phumza P Wainberg Milton L ML

Study Outcome 

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Statistics
Citations :  Ali G-C, Ryan G and De Silva MJ (2016) Validated screening tools for common mental disorders in low and middle income countries: A systematic review. PLoS One 11(6), e0156939.
Authors :  16
Identifiers
Doi : e4
SSN : 2054-4251
Study Population
Male,Female
Mesh Terms
Other Terms
assessment tools;cross-cultural;developing countries;primary care;psychometric evaluations
Study Design
Cross Sectional Study
Study Approach
Country of Study
South Africa
Publication Country
England