Addressing Adolescent Depression in Primary Care: Building Capacity Through Psychologist and Pediatrician Partnership

Costello, Lisa; Suh, Christina; Burnett, Bridget; Kelsay, Kimberly; Bunik, Maya; Talmi, Ayelet

doi:10.1007/s10880-019-09680-w

Cited by 19 publications

(10 citation statements)

References 44 publications

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“…In another study done from January 2017 to August 2018 including 2107 adolescents, the percentage of positive screening was 11%. 16 We found improvement in the screening rates and documentation rates along with an increase in the rate of referral to mental health services. The screening rate improved to 50% by mid-cycle (PDSA cycle 3), and up to 70% at the end of the 5-month period (PDSA cycle 5).…”

Section: Discussionmentioning

confidence: 65%

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Implementing the Patient Health Questionnaire Modified for Adolescents to improve screening for depression among adolescents in a Federally Qualified Health Centre

et al. 2020

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BackgroundDepression, which is a serious medical illness, is prevalent worldwide and it negatively impacts the adolescent lifestyle. Adolescent depression is associated with adverse emotional and functional outcomes and suboptimal physical health. Over the last decade, it has been found that approximately 9% of teenagers meet the criteria for depression at any given time, and one in five teenagers have a history of depression during adolescence. Ninety per cent of paediatricians believe that recognition of child and adolescent depression is their responsibility; however, it has been reported that 46% lacked confidence that they could recognise depression.MethodsIn this study, adolescents between 12 and 17 years of age were screened during their well-child visits using the Patient Health Questionnaire Modified for Adolescents. A score of 10 or higher warrants a referral to a social worker and psychiatrist. The goals of this quality improvement project were to implement a standardised questionnaire and to improve the screening, diagnosis and treatment of depression in children from 12 to 17 years of age.ResultsIt was found that the adolescent depression screening rate significantly improved within 6 months of implementing this quality improvement project. The screening rate improved to 50% by mid-cycle (Plan-Do-Study-Act (PDSA) cycle 3) and up to 70% at the end of the 6-month period (PDSA cycle 5). Improvement was noted among all providers, across all age groups, and in both male and female patients by the end of the study period.ConclusionStandardised screening tests with a scoring system help providers to identify and monitor depression symptoms using a common language, especially in the outpatient clinical setting where the patient may be seen by different providers.

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Section: Discussionmentioning

confidence: 65%

“…In another study done from January 2017 to August 2018 including 2107 adolescents, the percentage of positive screening was 11%. 16 …”

Section: Discussionmentioning

confidence: 99%

Implementing the Patient Health Questionnaire Modified for Adolescents to improve screening for depression among adolescents in a Federally Qualified Health Centre

et al. 2020

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“…Adolescent depression screening is currently recommended for pediatric PCPs, 33 and behavioral health screening programs have been shown to increase behavioral health care utilization. 34,35 However, many PCPs feel uncomfortable with navigating appropriate follow-up for youth who screen positive for depression. 36,37 Established adolescent depression and suicidality screening as part of routine care in the present study sample likely facilitated use of the integrated care model, potentially increasing the likelihood of ongoing follow-up for symptom monitoring and connection to appropriate treatment, as well as providing an opportunity for immediate risk assessment and safety planning.…”

Section: Discussionmentioning

confidence: 99%

Utilization of Integrated and Colocated Behavioral Health Models in Pediatric Primary Care

Hoff

Hughes-Reid

Sood

et al. 2020

Clin Pediatr (Phila)

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Integrating behavioral health services within pediatric primary care may help address barriers to these services for youth, especially the underserved. Models of primary care behavioral health include coordinated, colocated, integrated, and collaborative care. This study began exploring the comparative utility of these models by investigating differences in the demographics and diagnoses of patients seen for a behavioral health warm handoff (integrated model) and a scheduled behavioral health visit (colocated model) across 3 pediatric primary care sites. The 3 sites differed in their rates of warm handoff usage, and there were differences in certain diagnoses given at warm handoffs versus scheduled visits. Depression diagnoses were more likely to be given in warm handoffs, and disruptive behavior, trauma/adjustment, and attention-deficit/hyperactivity disorder–related diagnoses were more likely to be given in scheduled visits. These results have implications for the influence of office structure and standardized procedures on behavioral health models used in pediatric primary care.

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“…Over‐diagnosis may produce a resultant burden on pediatric health care systems 3,61 . However, a recent report from an integrated pediatric primary care system described an interesting algorithm which could mitigate this caveat 62 . Patients who presented with a negative screen (< 5) were checked for stress levels, social problems, deteriorating school performance, mood changes, and disrupted routines.…”

Section: Clinical Recommendationsmentioning

confidence: 99%

A pediatrician‐friendly review of three common behavioral health screeners in pediatric practice: Findings and recommendations

Trafalis

Giannini

Joves

et al. 2021

Pediatric Investigation

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Behavioral health concerns are surging in pediatric practices. Fortunately, integrated behavioral/medical health clinics are growing and child psychiatrists/psychologists are increasingly embedded in these care settings to help shoulder the clinical load. Routine screening of behavioral health problems in primary care facilities enables early identification and treatment. However, deciding on sound, efficient, and scalable screening measures is sometimes arduous. Accordingly, this article presents a clinician‐friendly review of three common instruments useful in screening pediatric behavioral health concerns including anxiety, depression, and conduct problems. Psychometric findings and clinical applications of the Pediatric Symptom Checklist‐17 (PSC‐17), the Patient Health Questionnaire‐9 (PHQ‐9), and the Screen for Child Anxiety Related Emotional Disorders (SCARED) are delineated. Finally, clinical implications and recommendations for practicing pediatricians and child psychiatrists are offered.

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Addressing Adolescent Depression in Primary Care: Building Capacity Through Psychologist and Pediatrician Partnership

Cited by 19 publications

References 44 publications

Implementing the Patient Health Questionnaire Modified for Adolescents to improve screening for depression among adolescents in a Federally Qualified Health Centre

Implementing the Patient Health Questionnaire Modified for Adolescents to improve screening for depression among adolescents in a Federally Qualified Health Centre

Utilization of Integrated and Colocated Behavioral Health Models in Pediatric Primary Care

A pediatrician‐friendly review of three common behavioral health screeners in pediatric practice: Findings and recommendations

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