Depression Screening & Follow-Up

The U.S. Preventive Services Task Force recommends that adolescents be screened for depression using a validated questionnaire, and only when systems are in place for diagnosis, treatment, and follow-up.

Depression Screening & Follow-Up Case Examples

Back to Top

SBHCs in North Carolina discovered that there were two important steps in effectively screening clients for depression. The first was to identify a standardized depression screening tool that both primary care and behavioral health providers could use. The second was to pinpoint a centralized area within the EHR where providers could quickly reference previous screening dates and outcomes (positive or negative) during any type of visit and then determine in real-time if they needed to conduct another screening. Once trained in using the screening tool and documenting results, providers could track positive and negative scores to better identify and follow-up with patients who screened positive for depression.

Other Resources

Back to Top

Do you have a promising strategy or resource you believe would be helpful to other SBHCs working to increase the number of SBHC clients with a well child visit? Share it with us by sending an email to info@sbh4all.org and we’ll post it here!

Frequently Asked Questions

Back to Top

  • Conduct a brief depression screening during each well-child visit and/or new client visit.
  • Identify an area within the EHR (i.e. flowsheet) where a provider can quickly reference previous screening dates and outcomes (positive or negative) during any type of visit and then determine in real-time if they need to deliver another screening. This can also be helpful if you have patients who are seen across multiple sites using the same EHR system.
  • Engage in education and awareness-raising activities that inform youth that your SBHC offers screenings and referrals for depression and other mental health issues, not just physical health care.
  • Develop shared care plans with SBHC clients who receive primary and behavioral health care services so all providers can access those care plans.
  • Consider using an evidence-based screening tool like the PHQ2 as a brief, initial screen. The PHQ9 can be administered as a follow-up screen or as the initial screen, if time allows. Both have been validated for use with adolescent populations.
  • Build a discrete field in your EHR to enter screening scores and to indicate whether the screen was positive or negative. Check with your EHR vendor or support services — you may have an applicable function(s) you’re not aware of that you can use, such as a flowsheet. This would allow you to add a discrete field to capture this data.
  • If your risk assessment already includes a depression screen, count those visits toward the number of students with a depression screen.
  • You can also create a discrete field to note that you completed a depression screening as a separate service from the WCV or risk assessment, and another discrete field to track the screening results and any follow-ups plans that were made.

Telehealth Ideas

Back to Top

  • At the beginning of each session, confirm the location and call back number of the students to send help if indicated
  • When possible and appropriate, engage caregivers in screening for depression
  • If video capability is available, consider sharing the screen to show screening tool. Some students may feel more comfortable responding to questions as they read along.
  • Seeing students at home may provide additional insight into depression symptoms. For example, if a student’s appointment is at noon, and they cannot get out of bed, this gives the provider more information about student functioning.