Original Research

Clinical validation of brief mental health scales for use in South African occupational healthcare

Charles H. van Wijk, Jarred H. Martin, David J.F. Maree
SA Journal of Industrial Psychology | Vol 47 | a1895 | DOI: https://doi.org/10.4102/sajip.v47i0.1895 | © 2021 Charles H. van Wijk, Jarred H. Martin, David J.F. Maree | This work is licensed under CC Attribution 4.0
Submitted: 01 March 2021 | Published: 30 August 2021

About the author(s)

Charles H. van Wijk, Institute for Maritime Medicine, Simon’s Town, South Africa; and, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
Jarred H. Martin, Department of Psychology, Faculty of Humanities, University of Pretoria, Pretoria, South Africa
David J.F. Maree, Department of Psychology, Faculty of Humanities, University of Pretoria, Pretoria, South Africa


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.


CAGE; clinical screening; GAD-7; occupational health surveillance; occupational mental health; PC-PTSD-5; PHQ-9


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Crossref Citations

1. Appraising Psychological Adaptation During Covid-19 in South Africa: A Descriptive Study Illustrating the Need for Multi-Model Monitoring of Mental Health
Charles H. Van Wijk
SAGE Open  vol: 13  issue: 4  year: 2023  
doi: 10.1177/21582440231218576