Quality mental healthcare starts with an accurate understanding of each patients' symptoms and experiences. While diagnostic frameworks such as the Diagnostic and Statistical Manual of Mental Disorders 5 (DSM-5) provide a framework for evaluating and categorizing each individuals' mental health symptom into discrete categories, the truth is that landing on an accurate diagnosis can sometimes be difficult. This is especially the case when initial evaluations rely solely on verbal reports and a clinical interview with no use of self-report diagnostic screening tools.
Why might this be?
While many of our patients are comfortable disclosing important health information to us during their appointments, many are not. Even if we, as clinicians, are able to accurately ask the right questions to screen for the range of mental health disorders within our clinical interview (a difficult feat in its own right), not everyone we work with is comfortable being that forthcoming early on in treatment. As a result, misdiagnosis - or the more common form of missing diagnoses - is increasingly prevalent in our clinical community.
For example, one study out of John Hopkins observed more than 5,600 patients with a depression diagnosis and found that up to 60% of these patients didn't actually have the disorder according to DSM-5 criteria. On the other end of the spectrum, many mental health diagnoses that represent serious mental illness, such as schizophrenia and bipolar disorder, are often under-diagnosed as depression or anxiety, leading to treatment plans that simply aren't effective.
While a widespread solution for the problem of misdiagnosis is well beyond this blog post, a first step in the right direction is the implementation of ubiquitous screening measures for anyone seeking mental health treatment. This is because some patients disclose sensitive information more readily via self-report questionnaires. This, in turn, can aid in detecting atypical symptoms that may be associated with otherwise missed diagnoses. Furthermore, utilizing screening measures upon starting treatment with new patients is a simple and effective safeguard to ensure that we are catching any information that we may have otherwise forgotten or failed to ask during our standard appointments.
At Blueprint, our mission is to ensure that all of our partner clinics have access to a user-friendly standardized screening instrument in order to reduce the prevalence of misdiagnosis in mental health treatment and ensure that all patients are receiving the care that they need. In this way, we are excited to announce the release of the Blueprint Diagnostic Screener (BPDS).
The BPDS uses 25 questions to screen for 15 different diagnostic domains relevant to mental health and wellness. Moreover, the Blueprint platform automatically assigns outcome measures based on each domain that was screened positive, thus ensuring that each patients enrolled on Blueprint is receiving personalized measurement-informed care that is tightly connected to their unique profile of symptoms and experiences.
The foundation of the BPDS was build using an existing validated screening measure, the DSM-5 Level 1 Cross Cutting Symptom Measure. Our team used the original measure's items and clinical cutoffs in creating the BPDS and added additional logic and decision making capabilities to enhance the usability and automation of the end-to-end screening process which thus represents the BPDS's unique offering. We then added two additional clinical domains to account for common conditions often seen in group practice settings that were not adequately addressed in the original DSM-5 version - trauma and eating pathology. The trauma screening item was derived from the Single Item Trauma Screen and the eating pathology screening item was derived from original research from Blueprint's clinical team.
Ready to start using the BPDS with your own clients?! You can start here to learn more about the specific workflows and protocols that make the BPDS unique.