Development and validation of a mental health screening tool for asylum-seekers and refugees: The STAR-MH
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2018-03-16
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BMC Psychiatry
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BMC
Melbourne Authors
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Florey Department of Neuroscience and Mental Health
Psychiatry
Psychiatry
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Journal Article
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Hocking, D. C., Mancuso, S. G. & Sundram, S. (2018). Development and validation of a mental health screening tool for asylum-seekers and refugees: The STAR-MH. BMC Psychiatry, 18 (1), https://doi.org/10.1186/s12888-018-1660-8.
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Abstract
BACKGROUND: There is no screening tool for major depressive disorder (MDD) or post-traumatic stress disorder (PTSD) in asylum-seekers or refugees (ASR) that can be readily administered by non-mental health workers. Hence, we aimed to develop a brief, sensitive and rapidly administrable tool for non-mental health workers to screen for MDD and PTSD in ASR. METHODS: The screening tool was developed from an extant dataset (n = 121) of multiply screened ASR and tested prospectively (N = 192) against the M.I.N.I. (Mini International Neuropsychiatric Interview) structured psychiatric interview. Rasch, Differential Item Functioning and ROC analyses evaluated the psychometric properties and tool utility. RESULTS: A 9-item tool with a median administration time of six minutes was generated, comprising two 'immediate screen-in' items, and a 7-item scale. The prevalence of PTSD &/or MDD using the M.I.N.I. was 32%, whilst 99% of other diagnosed mental disorders were comorbid with one or both of these. Using a cut-score of ≥2, the tool provided a sensitivity of 0.93, specificity of 0.75 and predictive accuracy of 80.7%. CONCLUSIONS: A brief sensitive screening tool with robust psychometric properties that was easy to administer at the agency of first presentation was developed to facilitate mental health referrals for asylum-seekers and new refugees.