Document Type

Presentation

Publication Date

Spring 2025

Faculty Mentor

Corey Morrow

Abstract

In the United States, 26% of individuals report living with mental illness each year. Those with a disability are 5 times more likely to report symptoms of mental distress. Additionally, underinsured individuals are at increased risk of going undiagnosed and untreated.

A student-run free clinic that provides occupational therapy (OT), physical therapy, and speech therapy services to underinsured individuals implemented a new initiative to screen patients using the Patient-Health-Questionnaire (PHQ) assessment due to the higher risk of undiagnosed mental illness. However, with no dedicated mental health providers on staff, there was a need to develop a standard protocol for students and supervising clinicians to follow when interpreting a patient’s score on the PHQ. This would be particularly important if a patient’s PHQ score indicated suicidal ideation.

The purpose of this quality improvement capstone project was to improve how mental health was addressed at the clinic. A mental health screening protocol was developed and included step-by-step instructions for interpretation of a patient’s score on the PHQ assessment and referral information for local clinics that provide affordable and accessible mental health care. The protocol also included guidance for initiating a psychiatric evaluation via a community mental health center in the case of a mental health emergency. Additionally, an evidenced-based educational handout was created to provide OT students with strategies for addressing mental health conditions in their treatment planning. The handout included examples of mental-health based treatment ideas, sample phrases to start a conversation on mental health, strategies for therapeutic use of self, symptoms indicative of mental illness, and tips for documenting mental-health based interventions.

Of the patients who completed the PHQ assessment, none yielded a positive score, indicating that they are currently at low risk for depression. Additionally, a satisfaction survey revealed OT students found the sample phrases and treatment ideas to be the most helpful due to feeling intimidated when addressing mental health in the clinic.

In the United States, 26% of individuals report living with mental illness each year. Those with a disability are 5 times more likely to report symptoms of mental distress. Additionally, underinsured individuals are at increased risk of going undiagnosed and untreated.

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