Response to de Wit and Snoek W e agree with de Wit and Snoek's emphasis on the importance of discriminating between mental health screening in individuals and monitoring of health-related quality of life (HRQOL). As they describe, screening is aimed at case ascertainment, whereas monitoring is designed to track progress. Notwithstanding this important distinction, there is considerable overlap between various mental health/behavioral and HRQOL measures and, as we have previously demonstrated, it is possible to use HRQOL and behavioral tools in sequence in a screening protocol (3). This is not to imply that our strategy is the only way to screen but simply to point out that screening strategies do exist. Alternative tools such as those proposed by de Wit and Snoek appear to be equally valid.