Brief mental health screening of adults attending a free medical outreach clinic in Lima Peru reveals high psychological distress and thoughts of self harm

Abstract Background Short-term global health outreach experiences rarely include mental health screening despite substantial unmet need. We assessed anxiety, depression, sleep disturbance, and self-harm ideation among adults attending a pop-up free medical clinic in Lima, Peru. Methods Adults completed a Spanish-language, locally modified six-item PHQ-4 comprising the four validated PHQ-4 items and two locally added items assessing sleep disturbance and self-harm ideation. We calculated standard PHQ-4 screening outcomes, internal consistency, and the association between overall distress and self-harm ideation. Results Of 257 adult clinic patients, 205 completed screening (79.7%). Anxiety and depression screens were positive in 42.4% and 36.6%, respectively; 35.6% had moderate-to-severe distress, and 27.3% screened positive for both conditions. The core scale showed good internal consistency (Cronbach’s α = 0.81). Self-harm ideation was reported by 16.1% and was more common among patients with moderate-to-severe distress than among those below that threshold (34.2% vs. 6.1%; OR = 8.1, 95% CI 3.4–19.1, p < .001). Poor sleep was reported by 60.5%. Conclusions Brief screening identified substantial psychological distress and clinically meaningful self-harm ideation in a short-term primary care outreach setting. Mental health and safety screening may be feasible and informative in similar programs when paired with a clear local referral pathway.