Culturally Sensitive Technology-Enhanced Mental Health Screening in Integrated Primary Care

Abstract

The integration of primary care and mental health care is a requirement of the Patient Protection and Affordable Care Act of 2010 and has challenged primary care providers to address gaps in the quality of care provided for patients with mental health issues. Vulnerable populations, such as the American Indian people experience gaps in quality health care, especially communication gaps and language barriers. This quality improvement project used a survey design to explore the potential for primary care providers to adopt a culturally sensitive electronic mental health, screening tool to bridge communication gaps and language barriers. Primary care providers recruited from the Northern Arizona University (NAU) Campus Health Services clinic evaluated the concept of a touch screen iPad technology to implement the Patient Health Questionnaire-9 (PHQ-9), which screens for depression using audio options in English and in the Navajo language to accommodate American Indian patients. A PowerPoint overview of the iPad technology was sent via email to the NAU providers and included; the PHQ-9 screening results, which are to be immediately accessible in the patient's electronic health record along with a screening report. The screening report included the PHQ-9 depression score, interpretation of the score, best treatment choices, and a graph for monitoring patient progress. This survey results concluded providers perceive the iPad technology for mental health screening to be useful in their integrated primary care clinic. A modified Technology Acceptance Model (Davis, 1989) was used to evaluate the providers' perception of the iPad Technology, and the University of Arizona's Qualtrics survey system provided data analysis of the survey results.