PRIMARY CARE TEAM TOOLKITS
Screening
SCREENING TOOLKITS
Primary care team toolkits for screening of depression, anxiety, suicide, substance use disorder, and social determinants of health.
Screening Workflow Examples and Guides
AMA BHI Workflow Guide
American Medical Association
Actionable, evidence-based best practices on workflow design enabling primary care providers to overcome barriers to operationalizing integrated behavioral health care in their practice.
AMA Interactive Workflow Development Tool
American Medical Association
This resource is designed to help practices develop a successful BHI Workflow by identifying the people, processes, and tools required to ensure it runs effectively and efficiently.
AAFP Guide to Social Needs Screening
American Academy of Family Physicians
This resource is designed to help you effectively implement programs to identify and attend to the social factors depending on the specific needs of the patient population, the ability of the practice to assess these needs, and the availability of community resources.
Other Screening Resources
Alcohol Screening and Brief Intervention for Youth: a Practitioner’s Guide
NIH
A resource designed to help health care professionals quickly identify youth at risk for alcohol-related problems.
Screening, Brief Intervention, Referral to Treatment Resources
SAMHSA
A resource designed to help practices in the process of screening, conducting brief interventions and referring patients to treatment resources.
A practical Approach to Screening for Social Determinants of Health
FPM
A resource designed to help the process of screening patients to understand their social context is the gateway to addressing barriers and improving health.
Screening for Behavioral Health Conditions in Primary Care: A Systematic Review
NIH
A resource designed to help primary care physicians identify and evaluate publicly available, psychometrically tested tools that can be used to screen adult patients for common mental and substance use disorders.
Depression
Depression is common and impacts about 1 in every 3 patients that present in Primary Care. The Centers for Medicare & Medicaid Services requires enrollees in Medicare-Medicaid Plans to be screened for Depression on an annual basis and many ACOs and Value-Based Programs also require routine depression screening. Depression impacts people with chronic health conditions like diabetes, COPD, and heart disease. Targeted additional screening of these higher-risk patients can help identify needs earlier and improve overall health.
Anxiety
According to the Anxiety and Depression Association of America, people with anxiety disorders are three to five times more likely to go to the doctor and six times more likely to be hospitalized for psychiatric disorders than those who do not experience anxiety disorders. Because there is a significant overlap in mental and physical health symptoms related to anxiety, these disorders are often undiagnosed or misdiagnosed. Anxiety can present as worry and fear, but it can also present as anger, irritability, or even digestive issues. Anxiety often accompanies chronic conditions, such as COPD and Heart Disease. Regular screening for all patients is recommended. Targeted additional screening of patients at higher risk, such as those with chronic health conditions like heart disease or COPD, can maximize screening impact on the population.
Suicide
Approximately 45% of people who die by suicide visit their primary care doctor within one month of their death. Openly addressing suicide risk and asking questions can and does save lives. Evidence-based, publicly available, validated tools for suicide risk screening in medical settings that can be used to detect suicidal ideation or behaviors:
Substance Use Disorder
The goal of substance use screening is to identify individuals who have or are at risk for developing alcohol- or drug-related problems, and within that group, identify patients who need further assessment to diagnose their substance use disorders and develop plans to treat them. It is recommended to screen for substance use disorders regularly. A variety of screening tools are available and easy to integrate into primary care workflows.
Social Determinants of Health
Primary Care teams know firsthand how the social needs of patients can create serious access, adherence, or other barriers that can and do impact patient outcomes. Screening for these social determinants of health is increasingly endorsed and recommended as best practices by groups like CMS, and professional bodies like AAFP and other groups.
Protocol for Responding to and Assessing Patient’s Assets, Risks, and Experiences Tool
PRAPARE
NOTE: This toolkit does not include a comprehensive set of all available screeners. Screeners and questionnaires are not for diagnostic use, nor are they a replacement for your professional medical advice and judgment. For measures that are self-reported by the patient, clinicians should verify responses as part of the clinical interview.
