Effect of Routine Mental Health Screening in a Low-Resource Pediatric Primary Care Population

Objective. Despite evidence for its feasibility, the usage of mental health screening in primary care practices with overburdened providers and few referral options remains unclear. This study explores the effects of routine screening on mental health problem identification and management in a low-r...

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Bibliographic Details
Published in:Clinical pediatrics 2012-04, Vol.51 (4), p.359-365
Main Authors: Berger-Jenkins, Evelyn, McCord, Mary, Gallagher, Trish, Olfson, Mark
Format: Article
Language:English
Subjects:
Child
Female
Health Resources
Humans
Logistic Models
Low income groups
Male
Mass Screening
Mental Disorders - diagnosis
Mental Disorders - therapy
Mental health
Multivariate Analysis
Pediatrics
Primary care
Primary Health Care - standards
Primary Health Care - statistics & numerical data
Quality Improvement
Referral and Consultation - statistics & numerical data
Retrospective Studies
Urban Health Services - standards
Urban Health Services - statistics & numerical data
Waiting Lists
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Summary:Objective. Despite evidence for its feasibility, the usage of mental health screening in primary care practices with overburdened providers and few referral options remains unclear. This study explores the effects of routine screening on mental health problem identification and management in a low-resource setting. Methods. Medical records of 5 to 12 year-old children presenting for well visits before and after screening was implemented were reviewed. Multivariate logistic regression was used to explore associations between study period and identification/management practices. Changes in the number of visits and wait times for a co-located referral service were assessed post hoc. Results. Parents disclosed more mental health problems, and providers initiated more workups but referred fewer patients after screening was implemented. The proportion of new visits and wait times for the referral service did not change. Conclusions. Even in low-resource settings, screening may facilitate parental disclosure and increase clinical attention to mental health problems without overburdening referral services.
ISSN:0009-9228
1938-2707
DOI:10.1177/0009922811427582