Group administered mental status screeners?

[Justanothergrad]

I'm working with a mental health clinic to revisit their assessment practices. Their assessments are conducted, in part, using a group battery (usually 2-4 folks).

Are there any group administered mental status screeners that could be included as part of that process? The folks seen for testing in this setting should be pretty functional and so I don't expect a lot of neurocognitive impairment to get picked up.

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[smalltownpsych]

What exactly is a group battery? By assessment are you just referring to a general intake process? Why do they do it as a group? It just seems kind of odd.

 

[Justanothergrad]

What exactly is a group battery? By assessment are you just referring to a general intake process? Why do they do it as a group? It just seems kind of odd.

The facility has patients sit at a computer/desk away from others and take several tests, either using a computer (MMPI), completing self-report/paper & pencil, or with a projector for simultaneous admin of a single set of stimuli (Benton visual). Some of this is a throwback to the analytic push towards reading the data without individual appointments. Groups are 1-4 people. Individual testing is usually done earlier in the day.

I understand the clinic time for the MMPI but the rest is odd to me as well. I'm pushing for more individual testing, but I'm trying to push for several thing (MMPI-2 --> RF, etc.) that may or may not happen. I'm wanting to push towards a better mental status screener in group if I can't get them to incorporate some brief standard ones (trails, cowat, mmse, etc.) as part of all individual testing.

 

[WisNeuro]

I'm not much of a fan of the idea of group MSEs. The scores are already misread and misused, and I can only envision this increasing that problem. Just get some decent nurses trained on the MoCA so that the upper level providers don't need to incorporate it.

 

[Justanothergrad]

I'm not much of a fan of the idea of group MSEs. The scores are already misread and misused, and I can only envision this increasing that problem. Just get some decent nurses trained on the MoCA so that the upper level providers don't need to incorporate it.

Agreed that is a potential problem and you have no idea how much I'm on board with that approach. The purpose they would serve here is as an initial screen for neuro referral (which is what the benton is used for), so I'm trying to manage how they are interpreted. The clinic doesn't over-interpret them now and just uses them purely for screening and (even when someone says they are screened positive) aren't over-emphasized. It's just written into the recommendations for further eval.

The problem is its fighting an uphill battle with respect to some of how much of the system is willing/able to be changed. I'm pushing for bigger changes than I anticipate happening, so I'm also trying to have options to help shape the best practices within the scope of what they are doing. I'm not convinced that a group administered benton visual is the best/most sensitive MSE, thus my effort is to improve on the current screening practices in any way I can. Any suggestions on how to work within the system would be appreciated, on the chance that I don't get my way.

 

[WisNeuro]

Honestly, best bet is for some of the front-line providers (e.g., nursing) administering the MoCA in individuals where there is a question of reported cognitive or functional imapirment suggestive of a dementia. If they fall within certain levels, depending on community norms for age, consider a referral for more extensive testing by a neuropsych.