Mental health disorders cumulatively are the most costly health problem in American primary care.1 These disorders frequently go undiagnosed and undertreated. The U.S. Preventive Services Task Force recommends annual screening for depression, and, when positive, additional assessment for other comorbid psychological problems, such as anxiety, bipolar, posttraumatic stress (PTSD), and substance abuse disorders (SUD).2 These additional assessments are important, as 20% of primary care patients who screen positive for depression suffer from bipolar disorder, anxiety disorders are twice as prevalent as depression, and substance use disorders are often missed.3,4 These conditions are often comorbid with physical illnesses and greatly drive up the cost of care, with a negative impact on outcomes (see table below).5 The M3 Checklist is a research-validated screening tool that quantifies a patient’s risk for mental health disorders commonly found in primary care.6 Regular monitoring of patients with the M3 Checklist gives primary care access to measurement-based care and is a first step towards the integration of behavioral health into primary care.
1 Roehrig C, 2016. Mental Disorders Top The List Of The Most Costly Conditions In The United States: $201 Billion. Health Affairs 35(6):1130–1135.
2 Siu AL and USPSTF, 2016. Screening for Depression in Adults : U.S. Preventive Services Task Force Recommendation Statement. JAMA 315(4):380-387.
3 Angst J, et al., 2011. Prevalence and Characteristics of Undiagnosed Bipolar Disorders in Patients With a Major Depressive Episode. Arch Gen Psychiatry 68(8):791-799.
4 Kessler RC, et al., 2005. Prevalence, Severity, and Comorbidity of Twelve-month DSM-IV Disorders in the National Comorbidity Survey Replication (NCS-R). Arch Gen Psychiatry 62(6): 617–627.
5 Melek SP, et al., for Milliman, 2014. Economic Impact of Integrated Medical-Behavioral Healthcare. Report for the American Psychiatric Association.
6 Gaynes et al., 2010. Feasibility and Diagnostic Validity of the M-3 Checklist: A Brief, Self-Rated Screen for Depressive, Bipolar, Anxiety, and Post-traumatic Stress Disorders in Primary Care. Ann Fam Med 8(2):160.
The M3 Checklist is an evidence-based assessment which empowers providers by detecting, measuring and organizing symptoms of the following common mental health conditions: depression, anxiety disorders, bipolar disorder, and PTSD. Consisting of 27 question, the patient‐engaging web and mobile screening assessment can be easily completed during office visits, in the waiting or exam room, or remotely, in just three to five minutes. Once the assessment is completed, the M3 Checklist computes and assigns numeric values––the M3 Score and specific condition subscores––which can be used to provide clinical support. M3 Checklist provides structured mental health symptom data that can be integrated with most electronic health records using the standard laboratory data channel, allowing the data to be managed in the same manner as lab tests.
The care management team can track and measure changes over time and monitor the patient’s progress. The aggregated individual information provides population data available for analysis and reporting. Regular monitoring identifies patients who are not reaching their treatment targets and require adjustments in care. Aggregate mental health data can be integrated into the system’s larger data sets to be used in population stratification, analysis and quality improvement. A mental health registry is created from the compilation of a practice’s systematic screening and monitoring of patients’ M3 Checklist scores. This registry is used to monitor each patient’s score over time and can be used in quality reporting.