GREAT-25: A BRIEF MULTIDOMAIN PSYCHOLOGICAL SCREENING AND CLINICAL-ROUTING INSTRUMENT FOR COMMUNITY AND PRIMARY CARE SETTINGS
Keywords:
GREAT-25; Psychological Screening; Mental Health; Clinical Triage; Primary Care; Psychometric Validation.Abstract
Background: Brief transdiagnostic screening instruments are widely used to identify psychological signals warranting further clinical assessment, but existing global tools cover a limited number of symptom domains and are rarely adapted to the linguistic and cultural presentation of distress seen in Pakistani clinical and community settings.
Objective: This article describes GREAT-25, a 25-item, 19-domain screening-and-routing instrument developed for use in public-sector hospital, primary care, and community outreach settings, and situates it against established transdiagnostic screeners.
Method: We describe the instrument's structure, scoring framework, and intended clinical use, drawing an explicit parallel to the screen-confirm-diagnose-treat model used in routine laboratory medicine.
Results: GREAT-25 spans more clinically labeled domains than comparable instruments such as the DSM-5-TR Level 1 Cross-Cutting Symptom Measure (13 domains), while remaining brief enough for single-sitting administration.
Conclusion: GREAT-25 is proposed as a signal-detection and referral tool, not a diagnostic instrument; its clinical utility depends on downstream referral capacity and on planned psychometric validation, which is outlined.
