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
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.
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 firstname.lastname@example.org and we’ll post it here!
Frequently Asked Questions
What are some promising strategies I can use to increase the number of SBHC clients screened for depression?
- 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 a depression screening is already part of a WCV or risk assessment, how can we separate the screen in order to report it?
- 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.