Comprehensive quality evaluation of mental health content

The comprehensive quality evaluation of mental health content is essentially not a screening tool that labels individuals as "healthy/abnormal", but a dynamic evaluation system that takes into account individual differences, scene adaptation, and long-term development attributes. Its core goal is to help the evaluation subjects find a psychological support path that suits them, rather than classifying mental health levels.

When I helped three public middle schools in an eastern district implement mental health assessment projects two years ago, I encountered a particularly typical pitfall. At first, to save trouble, we directly used the SCL-90 scale, which is commonly used in the industry. In the valid questionnaires collected, 21% of the students were marked as "suspected of psychological abnormalities." The school was shocked at that time, and quickly organized full-time psychological teachers to interview these children one by one, and finally screened out those who really needed intervention. Less than 2% of the children predicted - half of the remaining children had just finished the test the day before and fell 180 places in the rankings. Others had a quarrel with their parents the night before because of puppy love and playing with mobile phones. There was even a boy who sprained his foot while playing basketball that morning.

Speaking of which, I have to mention the differences that have been quarreling in the industry for almost ten years. From the perspective of clinical psychology, especially practitioners with a psychiatric background, standardized scales and unified norms are the bottom line that must not be relaxed. After all, if the evaluation scale is adjusted casually, it is easy to miss high-risk groups such as depressive disorder and bipolar disorder, and no one will be held responsible if something goes wrong. Of course, I am not saying that standardized scales are useless. For example, in the initial screening of psychiatric outpatient clinics, standardized scales are very efficient. There are so many outpatient clinics across the country that receive hundreds of patients every day. It is impossible to chat for two hours with every first-time patient, and the resources cannot keep up. But practitioners in developmental psychology and community psychological services on the other side completely disagree with this statement. You take a scale made for 30-year-old professionals and give it to 12-year-old junior high school students. It even includes questions such as "Is sexual function normal?" The children are confused after reading it. What reference value can the test results have? Not to mention the evaluation of special groups such as left-behind children, postpartum mothers, and patients with serious illnesses. The sources of stress they face are different from ordinary people. Taking the universal norm card is a desperate situation.

A while ago, I encountered an even more outrageous thing. The HR of an Internet company in Hangzhou spent 9.9 yuan to buy an "Employee Mental Health Assessment Package" online. More than 200 people in the company took the test, and half of them were marked with "severe depressive tendencies." The HR was so frightened that he quickly contacted the EAP agency to prepare for crisis intervention. As a result, his team passed the test. I did one-on-one interviews for three days, and in the end only three people were really prone to depression. The rest were either filled in randomly when they were fishing, or they were deliberately chosen to be serious and wanted to take advantage of the company's paid psychological leave. There were also a few programmers who had just stayed up all night to fix bugs the day before, and their minds were confused. They didn't read the questions at all when they chose.

I have been in this business for almost 6 years, and I have been through a lot of pitfalls, and I have gradually learned some practical skills. To be honest, how can there be any 100% perfect evaluation system? If you want to focus on efficiency, you have to sacrifice part of the accuracy. If you want to focus on fully adapting to individuals, it is impossible to promote it on a large scale. It is essentially a trade-off. For example, when we evaluate schools now, we will cut off one-third of the irrelevant questions from the general scale and add questions that are more relevant to children's lives, such as "Are you happy getting along with your classmates?" and "Do you find school boring?" For incidents that may affect emotions, after the assessment results come out, we will never send a report directly to the students. Instead, we will synchronize with the class teacher and psychology teacher first. If there are suspicious situations, we will first understand them from the side. We will not go to the children and say "your assessment shows that you have psychological problems" - then you will scare the children who have no problems at all into problems.

In fact, mental health evaluation is especially like measuring your blood pressure. The value measured just after a run or an argument with someone is inherently inaccurate. You need to calm down and measure it several times, combined with your usual symptoms of dizziness and chest tightness, to make a comprehensive judgment. You can't just label someone as having high blood pressure once your blood pressure is high, right? Many people's current misunderstanding about mental health evaluation is that they think that once a lifetime is measured, they will label themselves "depression" or "anxiety disorder" based on the results of one evaluation. This will only make themselves more stressed, which is completely unnecessary.

Until now, the industry has not come up with a unified standard that everyone agrees with. After all, people's hearts are much more elusive than the most complex algorithms. To put it bluntly, we in this industry are not judges. We don’t have to give everyone a score or ranking for their mental health. It’s enough to be able to give people who need help a step through evaluation and let them know that their current state is normal and that there are ways to adjust.