MHA Screening provides tools for people to understand and make decisions about their own mental health. Our work supports individuals at the earliest stages of concern. This period is when individuals are most vulnerable to poor outcomes but also where intervention has the best chance for building resiliency and change. The voluntary data from users helps to identify data-driven population health efforts toward prevention and early intervention of mental illness, promotion of mental wellbeing, and equitable allocation of mental health treatment and supports.
MHA Screening Programs
The same way you go to providers to check on your physical health, checking up on your mental health is essential in ensuring you stay mentally healthy. One of the quickest and easiest ways to determine whether you are experiencing symptoms of a mental health condition is to take an anonymous screen. A screening is not a diagnosis, but a way of catching mental health conditions early, and understanding if your symptoms are having enough of an impact that you should start a conversation with your doctor or a loved one about your mental health.
MHA Screening is a collection of online, free, confidential, anonymous, and scientifically validated screening tools for depression, anxiety, bipolar disorder, eating disorders, post-traumatic stress disorder (PTSD), postpartum depression, alcohol and substance use, early psychosis, work health, as well as screens that are youth-focused and parent-focused. After completing a mental health screen, individuals receive immediate results, information, DIY tools and coping skills and linkage to treatment resources. Along with the results of their screens, individuals provide MHA with valuable demographic and survey responses that allow us to further support our mental health advocacy and education efforts.
History of Screening
MHA Screening was launched in 2014, with screens for depression, anxiety, bipolar, and posttraumatic stress disorder (PTSD).
Screening was launched to meet people with mental health resources where they are. This means two things:
- Provide screening in an online space. We know that when people first start experiencing mental health problems, they look for answers and resources online, the same way we often do for our physical health. We also know that there are many people who currently do not have access to mental health care. MHA Screening works to make sure that people have free access to clinically validated tools to check on their mental health where and how they are searching for them.
- Provide screening for people wherever they are in their mental health journey. Many people who access screening are experiencing the symptoms of a mental health condition for the first time. However, others use screening to monitor their mental health, and to know when they should seek additional support. We want to make sure that people can find tools to check on their own mental health, get additional information early on, and have the tools to address their own mental health without having to wait to reach a point of crisis before receiving resources.
Screening 2 Supports
After launching MHA Screening for two years and gathering data from our users, MHA recognized the need for quality user driven information and supports.
While traditionally, the model for next steps after mental health screening was to immediately refer to treatment, we found that what screeners report they want most are:
- Additional information about mental health
- Worksheets, tools, or apps they can use to monitor their own health
- Engagement with peers and others who understand what they are experiencing
- Referrals to care, services, and supports
Since 2017, we have used that information gathered from our screening program to build out content designed to help connect our screeners with the information and resources they need. After someone takes a screen on www.mhascreening.org, they are given resources in the four buckets above, in clear, common language that isn’t necessarily tied to a diagnosis, that allows people to make their own decisions about their mental health.
To learn more about Screening 2 Supports, click here.
Take a Screen
Screening is an anonymous, free, and confidential way to learn about your mental health and if you are showing symptoms of a mental illness.
A screening only takes a few minutes, and after you are finished you will be given information about potential next steps based on the results. A screening is not a diagnosis, but it can be a helpful tool for understanding where you are with your mental health, finding a starting point for getting more information and starting a conversation with your doctor or a loved one.
We serve 1 million users a year and these individuals provide insight on how we can continue to support our communities. Since the launch of screening, over 5 million people have completed an online screen, averaging about 3,000 screens a day.
Our goal is to use screening data to rapidly analyze and disseminate information to help fill unmet needs and gaps in care for our communities.
We are analyzing data based on correlations between screens and results, demographic questions, special populations (e.g. veterans, mothers, LGBTQ+), geography, special needs (e.g. comorbid health conditions, trauma), and access to care.
Lessons from Covid-19 and Race Equity
Since January 2020, MHA has seen an increase in number of mental health screens and severity of results that mirror the growing concerns from both the COVID-19 pandemic and race based trauma.
In an effort to build collaboration on real time data, MHA is working to publish monthly analyses of our data as it relates to COVID-19 and race.
Visit our page How Race Matters: What We Can Learn from Mental Health America’s Screening in 2020 to see results.
Lessons from 5 Million Screens
Among MHA screeners, the most common screening taken is for depression, but anxiety screenings have increased dramatically in 2020.
Among our first five million screeners, more than 45 percent screened for depression – the most common mood disorder – while an additional 19 percent screened for bipolar disorder and 14 percent screened for anxiety. These were among the first four screening tools available when the program launched in 2014.
In recent years, as more tools were offered, people screened more widely for other conditions. In 2019, for example, depression screeners represented 36 percent of all screens taken, followed by anxiety at 18 percent, bipolar at 15 percent, and psychosis at 14 percent.
But through the first few months of 2020, anxiety screening increased significantly as the pandemic took hold. Through mid-May, the share of anxiety screenings rose from 14 percent overall in 2014-2019 to 22 percent of 2020 screenings.
Significant percentages of screeners are positive, but most of these either have never been diagnosed, are not currently in treatment, or are receiving treatment that isn’t working for them.
MHA’s screening population is a help-seeking population, many of whom have never been diagnosed with a mental health condition or treated for one or have stopped treatment in the past. Among all screeners:
- 3.7 million, or 73 percent, screened “positive” or “moderate to severe” for the condition for which they screened.
- Of nearly 2 million people in this positive group who were asked if they had ever been diagnosed or received mental health treatment in the past, 60 percent – or 1.25 million people – said that they had not.
- And of those who when asked said that they had received treatment in the past, 55 percent – or more than 216,000 – were no longer receiving any treatment at the time they took a screen.
For a period of time, MHA surveyed those currently in treatment to find out why they were taking a mental health screening. Of the 83,825 who answered this question, 41 percent said their treatment was working but something else was going on, and 40 percent said either that they weren’t getting the help they needed or that their treatment no longer was working for them.
MHA screeners are young, which is consistent with the age of onset of most serious mental health conditions.
Mental health concerns are concentrated among younger people. Among MHA’s 3 million screeners who provided their age, 64 percent were under the age of 25, with half of that group under the age of 18. This is consistent with national data suggesting that half of all mental illnesses emerge by the age of 14 and three-fourths by the age of 25 – and so we would expect the vast majority of screeners to be young. Young people experience more moderate to severe depression and anxiety than all other age groups.
But while two million screeners were under the age of 25, MHA screening has reached many thousands not in this age group. Nearly 100,000 screeners, for example, are over the age of 55, offering valuable insights into mental health conditions affecting the population as we age.
MHA screeners are representative of the racial and ethnic diversity of the population. In addition, students, LGBTQ, caregivers, military, and trauma survivors all screen in large numbers.
MHA screening reaches important segments of the population. Screeners are predominantly female (74 percent), reflecting a lower inclination among males to talk about mental health problems. Otherwise, the screening population is a diverse one: 64 percent white/non-Hispanic or Latino and 36 percent racial/ethnic minority. Among racial or ethnic minority groups, the following numbers of screeners self-identified:
- 350,086 Hispanic or Latino
- 250,399 Asian or Pacific Islander
- 224, 868 Black or African American
- 154,421 Mixed Race
- 31,421 Native American or American Indian
These volumes offer meaningful opportunities to compare and analyze data across population groups.
- 1.7 million screeners identified as students
- 557,810 identified as LGBTQ
- 135,445 identified as caregivers
- 76,871 as veterans or active duty military
- 72,789 as new or expectant mothers
- 163,024 identified as trauma survivors (trauma survivor was not added as an option until 2018. In 2019, 23 percent identified as trauma survivors).
People seeking help for their mental health are also frequently living with other serious chronic health conditions.
More than 578,000 screeners reported living with other chronic health conditions. The most common one reported – by 179,609 (31 percent) of those reporting another chronic condition – was chronic pain or arthritis. More than 71,000 screeners reported having COPD or other lung conditions, more than 71,000 reported having diabetes, more than 48,000 reported having heart disease, and more than 15,000 reported having a movement disorder. More than 6,600 reported having cancer, and 3,600 reported having dementia.
People seeking help are not just looking for referrals to treatment services, they are also looking for information, peer and family support, and tools they can use themselves.
Roughly one third of screeners (1.7 million) responded to a question about what they would do with their screening results. Slightly more than 500,000 screeners said that they planned to discuss their screening results with a professional, family member, or friend.
While 31 percent of the 1.7 million people who answered that question said that they planned to take no action, of the 1.1 million screeners who said they wanted help, 45 percent (506,000) wanted to receive additional information about mental health (45%, N=506,340), followed by 42 percent (471,000) who wanted online or mobile programs to help track or manage symptoms and 40 percent (454,000) who said they wanted worksheets or coping skills to use at home. An additional 28 percent (320,000) wanted to be connected to a provider or support organization.
Our Population Health Research Interests
Part of the mission of the MHA online screening program is to further data-driven, upstream, population-level efforts to improve mental health. MHA Screening is not only the largest existing data set of help-seeking individuals for mental health conditions, but it collects data in real time – as people are actively taking screens. This allows MHA to recognize and respond to changes and trends in the mental health of the nation faster than any other data set in the country, as we did with our COVID-19 response.
When someone takes a screen, we ask for optional demographic information from screeners, which allows us to understand who is experiencing severe mental health challenges, what their experiences are, and what resources and supports they are looking for, especially among low-income and racially or ethnically diverse populations that are often left out of mental health research. Through future research with MHA Screening, we hope to use this information for prevention of mental health conditions, especially by addressing root causes and social determinants of health; increased access to early intervention; and more equitable development and allocation of mental health resources and supports.
We are always looking for researchers to help us explore new possibilities with our data and collaborate with us to further population-level mental health research. If you are a researcher and are interested in working with us, please email Maddy Reinert at firstname.lastname@example.org and Theresa Nguyen at email@example.com
MHA uses data to engage in public education and to advocate for better, data-driven, person-centered policy and programmatic work.
Below are some of the reports we have created using our findings from the online screening program:
- Early, Equitable and Trauma Responsive Care for Chronic Pain and Mental Health: explores the data collected from the 161,363 individuals who self-identified as living with arthritis or other chronic pain and completed a mental health screen from 2015-2019, including an in-depth qualitative and quantitative analysis of responses to learn more about barriers to care from a smaller subset of 38,000 screeners in 2019.
- LGBTQ+ Mental Health: Insights from MHA Screening: explores the data from the nearly 300,000 LGBTQ individuals who took a mental health screen from 2017-2019. Through this analysis, we highlight the specific challenges faced by LGBTQ individuals, particularly youth, and provide specific policy and programmatic recommendations to ensure them necessary, appropriate and timely support.
- 2020 Creating a Healthy Workplace Report: explores similarities and differences in answers to our Work Health Survey questions across two different populations - people seeking resources on Screening 2 Supports and a general population sample.
- 2019 Mind the Workplace Report: measured the attitudes and perceptions of nearly 10,000 employees in the U.S. on supervisor communication, company culture, and employee engagement and wellbeing.
- Lessons Learned from Online Depression Screening: includes state-level and demographic analysis of depression screening data from May 2014 through December 2016.
- Addressing Trauma in Youth: an exploration of data collected from 569 youth trauma survivors who took the Youth (Pediatric Symptom Checklist) screen.
- Mind the Workplace: analyzed over 17,000 employee surveys across 19 industries in the United States with a focus on workplace culture, stress, employee engagement, and employee benefits to measure workplace stress levels and overall mental health.
Collaboration Through Research
MHA Screening is the largest existing data set of help-seeking individuals for mental health conditions in an online space. In our screening program we use voluntary demographic questions and additional surveys to learn more about people who are often not captured in traditional research. Our data provides us an opportunity to better understand and disseminate findings on unmet needs and gaps in care among specific populations, such as youth, trauma survivors and LGBTQ+ individuals. Our work is designed primarily to provide the earliest supports to people in need. Our findings also help to create better public education, materials for providers to use in clinical care, and better inform future research and interventions.
Below is a summary of past research with links to published findings.
- Zhang, L., Duvvuri, R., Chandra, K. K., Nguyen, T., & Ghomi, R. H. (2020). Automated voice biomarkers for depression symptoms using an online cross-sectional data collection initiative. Depression and anxiety.
- Dannenberg, M.D., Bienvenida, J.C. M., Bruce, M. L., Nguyen, T., Hinn, M., Matthews, J., ... & Barr, P.J. (2018). End-user views of an electronic encounter decision aid linked to routine depression screening. Patient education and counseling.
- Bergmann, P., Lucke, C., Nguyen, T., Jellinek, M., Murphy, J. (2018) Identification and Utility of a Short Form of the Pediatric Symptom Checklist Youth Self-Report (PSC-Y). European Journal of Psychological Assessment. Accepted for publication.
- Murphy, J.M., Nguyen, T., Lucke, C., Chiang, C., Plasencia, N., & Jellinek, M. (2017). Adolescent Self-Screening for Mental Health Programs; Demonstration of an Internet-Based Approach. Academic Pediatrics. doi:10.1016/j.acap.2017.08.013
- Project with the Center for Behavioral Intervention Technologies (CBITs) at Northwestern and the University of Toronto. The project investigates the feasibility and impact of text based interventions post screening.
- Project with University of California, Irvine and Northwestern University titled: A Crowd-Powered Technological Treatment for Depression and Anxiety. The project investigates using crowd resourced information to build improved digital application tools using cognitive behavioral therapy.
- Project with Kaiser’s Mental Health Research Network titled: Building Capacity for Stakeholder Engagement in the Mental Health Research Network. The project increases capacity and dissemination for patient participatory research in mental health.
- Investigation with the Creative Research into Engaging Applications for Timely Interventions in Mental Health at University of Washington and the Center for Behavioral Intervention Technologies (CBITs) at Northwestern to analyze MHA’s depression data from 2014 – 2017. The project goal is to establish best practices in evaluation and use of digital based tools in mental health.
- Investigation with the University of California San Francisco evaluating MHA’s psychosis data from 2014 – 2017. The project goals are to evaluate the association between thresholds among symptom presentation that lead to help seeking behavior.
Want to Collaborate?
We are always looking for researchers to help us explore new possibilities with our data and collaborate with us to further mental health research. If you are a researcher and are interested in working with us, please email Theresa Nguyen at firstname.lastname@example.org and Maddy Reinert at email@example.com.