Validation of Global Mental Health Assessment Tool in Western Development Region, Nepal: A Cross Sectional Study

Main Article Content

Laxman Datt Bhatt
Shankar Singh Dhami

Abstract

Introduction: Global Mental Health Assessment Tool Primary Care Version (GMHAT/PC) is comprehensive tool that can encompass wide array of mental health problems. This can be used by health professionals in detecting and managing mental disorders in primary care and general health settings.


Methodology: A Cross sectional study was carried out in western regional hospital Kaski to validate and examine feasibility of Global Mental Health Assessment Tool Primary Care Version (GMHAT/PC) in Western Development Region, Nepal. The GMHAT/PC tool and semi structured questionnaire was used to collect data. Interview was taken by the paramedical person with Proficiency Certificate Level (PCL) in General medicine qualification.


Data were analyzed using SPSS-16 version. Sensitivity and specificity were calculated to measure the validity of GMHAT/PC. Positive Predictive Value (PPV) and Negative Predictive Value (NPV) of tool, positive and negative likelihood ratio were calculated. Cohen's Kappa statistics was calculated to determine inter-rater reliability for the tool. Average time taken for the interview, patient satisfaction and completion of interview by the patient was taken as an indicator of feasibility.


Result: The tool had good sensitivity 0.79 (95% CI: 0.73-0.85) and excellent specificity 0.94 (95% CI: 0.83 – 1). Overall there was a good level of agreement between psychiatrist and GMHAT/PC tool 0.76 (95% CI: 0.67 – 0.84). Likewise, overall Positive Predictive Value (PPV) of the test was excellent 0.98 (95% CI: 0.94 – 0.99) while Negative Predictive Value (NPV was fair 0.40 (95% CI: 0.24 – 0.56). And Likelihood Ratio Positive (LR +ve) of diagnostic agreement of the GMHAT/PC tool was 13.17 (95% CI: 2.01 – 90.67) and Likelihood Ratio Negative (LR –ve) was 0.22 (95% CI: 0.15 – 0.31). 


Conclusion: This study provides proven evidence to use Global Mental Health Assessment Tool Primary Care Version in specialist limited healthcare setting of Nepal. Findings of this study also support mid-level health workers and possibly others health workers having some training, can use the computer assisted programme GMHAT/PC to make a valid assessment and diagnosis for early detection and management of mental health related problem.

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How to Cite
Bhatt, L. D., & Dhami, S. S. (2020). Validation of Global Mental Health Assessment Tool in Western Development Region, Nepal: A Cross Sectional Study. Journal of Health Science and Alternative Medicine, 2(1), 12-18. Retrieved from https://he01.tci-thaijo.org/index.php/jhealthscialternmed/article/view/229038
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References

1. Copeland JR, Dewey ME, Griffiths-Jones HM: A computerized psychiatric diagnostic system and case nomenclature for elderly subjects: GMS and AGECAT. Psychol Med. 1986, 16: 89-99.
2. Behere PB, Sharma VK, Kumar V, Shah VA. MENTAL HEALTH TRAINING FOR HEALTH PROFESSIONALS : GLOBAL MENTAL HEALTH ASSESSMENT Edited by.
3. Prince M, Patel V, Saxena S, Maj M, Maselko J, Phillips MR, et al. No health without mental health. Lancet. 2007;370(9590):859–77.
4. Bhanderi D, Pandya Y. An epidemiological study of child marriages in a rural community of Gujarat. Indian J Community Med [Internet]. 2015;40(4):246. Available from: http://www.ijcm.org.in/text.asp?2015/40/4/246/164392
5. Mental Health and Substance Abuse , including Alcohol in the South-East Asia Region of WHO. 2001;(July).
6. Kohrt BA, Jordans MJD, Tol WA, Luitel NP, Maharjan SM, Upadhaya N. Validation of cross-cultural child mental health and psychosocial research instruments: Adapting the Depression Self-Rating Scale and Child PTSD Symptom Scale in Nepal. BMC Psychiatry [Internet]. 2011;11(1):127. Available from: http://www.biomedcentral.com/1471-244X/11/127
7. Regmi S, Sligl W, Carter D, Grut W, Seear M. A controlled study of postpartum depression among Nepalese women: Validation of the Edinburgh Postpartum Depression Scale in Kathmandu. Trop Med Int Heal. 2002;7(4):378–82.
8. Kohrt BA, Kunz RD, Koirala NR, Sharma VD. Validation of the Nepali version of beck anxiety inventory. J Inst Med. 2003;1–4.
9. Ehlers S, Gillberg C, Wing L. A Screening Questionnaire for Asperger Syndrome and Other High-Functioning Autism Spectrum Disorders in School Age Children. 1999;29(2):129–30.
10. Sharma VK, Lepping P, Krishna M, Durrani S, Copeland JRM, Mottram P, et al. Mental health diagnosis by nurses using the Global Mental Health Assessment Tool: A validity and feasibility study. Br J Gen Pract. 2008;58(551):411–6.
11. Psychiatrist C, Lecturer HS. Detecting mental disorders in primary care. 2009;11–3.
12. Wittchen H. Critical Issues in the Evaluation of Comorbidity of Psychiatric Disorders. 1996;168:9–16.
13. Croudace T, Evans J, Harrison G, Sharp DJ, Wilkinson E, McCann G, et al: Impact of the ICD-10 Primary Health Care (PHC) diagnostic and management guidelines for mental disorders on detection and outcome in primary care. Cluster randomised controlled trial. Br J Psychiatry. 2003, 182: 20-30.
14. Sharma Vk, Lepping P, Krishna M, Durrani S, Copeland JRM, Mottram P, Parhee R, Quinn B, Lane S, Cummins A: Can Nurses Make Accurate Mental Health Diagnosis Using GMHAT-PC? A Validity and Feasibility Study. Br J Gen Pract. 2008, 58 (551): 411-6.
15. Bishwajit G, O’Leary DP, Ghosh S, Sanni Y, Shangfeng T, Zhanchun F. Association between depression and fruit and vegetable consumption among adults in South Asia. BMC Psychiatry [Internet]. 2017;17(1):1–9. Available from: http://dx.doi.org/10.1186/s12888-017-1198-1
16. Meyer IH. Minority Stress and Mental Health in Gay Men. J Health Soc Behav [Internet]. 1995;36(1):38. Available from: http://www.jstor.org/stable/2137286?origin=crossref
17. Egede L: Major depression in individuals with chronic medical disorders: prevalence, correlates and association with health resource utilization, lost productivity and functional disability. General Hospital Psychiatry. 2007, 29 (5): 409-16.
18. Pharmaceutical R. Key points Validation and feasibility of the Global Mental Health Assessment Tool — Primary Care Version ( GMHAT / PC ) in older adults. :496–9.