Abstract:
ORIENTATION: South Africa carries a high burden of mental ill-health. Screening to identify
individuals for further referral is emerging as one pathway to promote access to mental health
interventions. Existing occupational health surveillance infrastructure may be a useful
mechanism for clinical mental health screening.
RESEARCH PURPOSE: This study explored the clinical validity of a range of brief mental health
measures in the context of occupational health surveillance.
MOTIVATION FOR THE STUDY: To meaningfully screen for mental health as part of occupational
health surveillance, tools are required that are empirically validated, clinically useful, locally
available and practical to administer.
RESEARCH APPROACH/DESIGN AND METHOD: Workers (n = 1816), recruited through workplace
occupational health surveillance programmes, completed the Patient Health Questionnaire-9,
Brief Symptom Inventory 18-somatisation subscale, Generalised Anxiety Disorder scale-7,
Primary Care Post-Traumatic Stress Disorder Screen, Intense (panic-like) anxiety scale and
CAGE scale and partook in a diagnostic interview with a clinical psychologist.
MAIN FINDINGS: Basic psychometric characteristics were reported, including confirmatory
factor analyses, measurement invariance, internal consistencies and socio-demographic
effects. Clinical utility was explored through receiver operating/operator characteristics
curve analyses, and calculations of positive and negative predictive values, as well as
sensitivity and specificity. These indicators provided evidence of clinical validity in the
study context.
PRACTICAL/MANAGERIAL IMPLICATIONS: The findings support the use of psychological screening
as a brief, practicable and easily accessible mode of occupational mental health support.
CONTRIBUTION/VALUE-ADD: This article presented evidence of structural and criterion validity
for these scales and described their clinical application for practical use in occupational
mental health surveillance.
