Mental Health Triage Tools for Medically Cleared Disaster Survivors: An Evaluation by MRC Volunteers and Public Health Workers

Objective: Psychological assessment after disasters determines which survivors are acutely distressed or medically compromised and what kind of assistance is needed (whether practical or psychological). A mental health triage tool can help direct more people to the appropriate type of help. The purpose of this study was to determine the effectiveness of the Fast Mental Health Triage Tool (FMHT) and the Alsept-Price Mental Health Scale (APMHS) among public health workers and Medical Reserve Corps (MRC) volunteers in conducting mental health triage. Both tools screen for ability to follow simple commands, chronic medical conditions, mental health conditions and services, occult injuries, and traumatic events in the past year. Both were designed for use in disasters where mental health resources are scarce and survivors are already medically triaged. Methods: Volunteers (n=204) and workers (n=66) were randomized into 3 groups, with 79 participating. Fifty-nine raters completed 20 each of 1180 mental health clinical vignettes of disaster survivors. Results: The survey presenting the vignettes was highly reliable at 0.771; the study model was parallel between baseline and treatment; and the interclass correlation among the raters was high at 0.852. Each rater triaged the same cases, but the rater was randomly assigned to use FMHT, APMHS, or no tool or scale. Between-subject effect for the tools used was significant (P=.039). The FMHT was significantly better than no tool in correct mental health triage, 67.3% to 51.5% (P=.028). Conclusion: The incorporation of a temporal component should be evaluated for potential inclusion in existing mental health triage systems.