Does Patient X Belong in the Mental Health Unit? The Importance and Impact of Proper Assessment Through the Validation of Emotion-Based and Cognitive-Based Measures

Mental health treatment programs often utilize a combination of clinical interview, observation, and emotion-based measurements to assess individuals and, ultimately, produce a diagnosis. It has been noted by practitioners and researchers alike (Pogge, 2014), that a nuanced differential diagnosis might remain obscured if cognitive challenges are not identified during an initial evaluation. A lack of resources or timely access can be a barrier to cognitive assessments, even if staff suspect a cognitive problem. If an intellectual impairment or developmental delay, such as autism, is overlooked, there can be a variety of consequences for the patient, including: misdiagnosis, ineffective treatment, psychological distress, and ultimately pre-mature discharge that results in a “revolving door” return that adds to institutional costs. Forty-eight participants, from three separate samples, completed a battery of cognitive- and emotion-based measures to evaluate their ability to provide a more comprehensive picture that aligns with measures in a supplementary way. Divergent and convergent validity were examined to evaluate how these measures aligned with various symptoms, as well as self-reported diagnosis. Results suggest expected indication of divergent validity between some measures of cognition and emotion (r = 0.01), as well as expected convergent validity between some measures of emotion and symptoms (r = -0.82,  p = 0.00). These findings suggest that the use of measures of cognition and emotion in evaluating mental health could enrich overall assessment and hopefully lead to greater diagnostic clarity. Assessing for cognitive challenges could reveal concerns that might sometimes be masked by sometimes red-herring, as neurocognitive flags do not present themselves on psychiatric, emotion-based screening tools utilized in mental health units. The addition of comprehensive psychometric assessment has the potential to circumvent unintended consequences of missed diagnosis and mislabeling, and would allow for multidimensional evaluation to enrich treatment planning. Additional research is needed to evaluate benefits and clarify what resources are needed to provide access to such assessments within mental health programs.