Suchergebnisse

A large number of individuals with developmental disabilities (DDs) go undiagnosed with mental health disorders as a result of being predominantly identified by their DDs. This biased treatment is referred to as diagnostic overshadowing and can stem from stigma and lack of education. It is often exacerbated by the inability to directly apply diagnostic criteria to this population. Despite the prevalence of these issues, these concerns are amenable to appropriate intervention, thus improving quality of care. Since social workers typically have a higher rate of contact with clients compared to other health care professionals, they may play a vital role in identifying the possible presence of mental health issues that otherwise have been overshadowed. The current practice note seeks to identify issues concerning the underdiagnoses of mental health issues in individuals with DDs, highlight their impact, and provide modifiable solutions.

BACKGROUND: Emergency departments (EDs) have the potential to promote critical public and preventive health interventions. Cervical cancer (CC) screening has been a cornerstone of preventive health efforts for decades. Approximately 20% of U.S. women are not adherent with CC screening guidelines—considerably below the U.S. Federal Government's target. ED patients are disproportionately nonadherent with CC screening guidelines. The ED, therefore, is an optimal setting to target women with an intervention that promotes CC screening. OBJECTIVES: To assess the feasibility and potential efficacy of an intervention, grounded in behavioral change theory, to promote uptake of CC screening among ED patients. METHODS: DESIGN: Randomized clinical trial pilot study; PATIENTS: Women aged 21–65 years that were identified in the ED to be nonadherent with CC screening recommendations; SETTING: Single center urban academic ED. Results: Among enrolled participants, 355 (79%) were determined to be adherent with screening recommendations and 95 (21%) were determined to be either nonadherent or have uncertain adherence. Among the nonadherent/uncertain group, 47 were randomized to the control condition (referral only) and 48 were randomized to the intervention condition. Thirty-six percent of participants in the control condition received or scheduled screening during the follow-up period. In the intervention condition, 43% received or scheduled screening during the follow-up period—a 19% relative improvement over the control condition. CONCLUSION: This pilot study demonstrates feasibility and preliminary efficacy of a behavioral intervention to increase uptake of CC screening among ED patients.