Online Program

Validating the modified mini screen (MMS) as a mental health referral screen for public assistance recipients in New York State

Monday, November 4, 2013 : 8:30 a.m. - 8:50 a.m.

Mary Jane Alexander, PhD, Center to Study Recovery in Social Contexts, Nathan Kline Institute, Orangeburg, NY
Deborah Layman, MA, Center to Study Recovery in Social Contexts, Nathan Kline Institute for Psychiatric Research, Orangeburg, NY
Gary Haugland, MA, Nathan Kline Institute, Orangeburg, NY
This study validated and developed guidelines for the Modified Mini Screen (MMS) to screen people receiving welfare benefits in New York State (NYS) for Mental Health (MH) conditions. Driven in part by lifetime limits on federal benefits, the proportion of people with MH conditions receiving welfare has increased but their MH service use is low. The welfare system may provide a point of access to MH services for underserved populations. A computer-assisted protocol delivered the MMS, demographic, and health-related questions (MOS-SF-12) to a representative sample of 490 welfare recipients. Telephone SCIDs identified a MH condition. Bivariate and ROC analyses were conducted to describe the sample, evaluate group differences, and validate the screen. Researchers found that 52% of participants met criteria for a non-substance-related lifetime MH condition. 36% met current criteria but 44% were not engaged in treatment. Participants with a MH condition reported more health problems, more disability days and lower levels of functioning than those without a MH condition. The MMS was reliable internally (Cronbach's alpha=.92) and over time (rho=.71). Accuracy was greatest when 7-9 items were endorsed (.81-.96, sensitivity; .69-.77, specificity). Therefore, the MMS is an accurate and reliable tool for guiding welfare system's MH referral practices. Screening and increased referrals may have a significant impact on local resources including behavioral health and primary care agencies. Implementation guidelines will take into account policy objectives, the impact on clients, treatment resources and local social service departments. Computer-assisted technology promotes access for people with varied literacy and elicits honest responses.

Learning Areas:

Other professions or practice related to public health
Provision of health care to the public
Social and behavioral sciences

Learning Objectives:
Describe the extent of Mental Health (MH) conditions and functional limitations among NYS beneficiaries Identify the psychometrics properties of the Modified Mini Screen (MMS) and optimal decision rules Discuss the potential implications of a MH screening tool with the welfare system on the local behavioral and primary care providers

Keyword(s): Mental Health Services, Screening Instruments

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: As Senior Research Scientist, Principal Investigator and Director of the NIMH P20 MH078188 Center to Study Recovery in Social Contexts, I am qualified to report on the validation study of the MMS.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.