Implementing Mental Health Screening in COVID-19 Survivors

Background: The COVID-19 pandemic has resulted in a myriad of lingering complex and chronic health and mental health problems with a current lack of standardized screening in the outpatient population. Proper management of mental health disorders relies on early screening and intervention for increased outcomes. Increased rates of COVID-19 diagnoses have resulted in new onset of mental health symptoms with limited access to necessary resources. The University of Utah established a Comprehensive COVID- 19 Clinic as a response to the needs of the "long-hauler" patient population. While the clinic provided screening for cardiac, neurocognitive, and pulmonary complaints, it did not assess screening for mental health concerns. The aim of this project was to implement mental health screening for COVID-19 "long- haulers" patients at the clinic. Methods: The intervention provided standardized screening in the form of the Patient Heath Questionnaire-2 (PHQ-2), Patient Heath Questionnaire-9 (PHQ-9), and Generalized Anxiety Disorder-7 (GAD-7) to patients in the Comprehensive COVID-19 clinic. Patients were also presented with a COVID-19 Survivor's Guide upon discharge from the clinic. Intake of the patient was performed by the clinical staff with the use of the PHQ-2. Based on scoring, subsequent screening (PHQ-9 and GAD-7) was presented to the patient. Physical and electronic copies of the COVID-19 Survivor's Guide were provided to the patient population upon discharge by the clinical staff and via AVS, the electronic discharge record. Results: A 94.4% (n=188/199) increase in screening was observed over a two-month time period in the Comprehensive COVID-19 Clinic. Usability was noted to be "easy overall" from clinical staff. High satisfaction was also reported from clinical staff in association with necessary conversations with patients regarding the impact of COVID-19 and associated anxiety and depression. Conclusion: This project has triggered an ongoing improvement initiative necessary for proper recognition and management of mental health disorders associated with the diagnosis of COVID-19.