Improving the Coordination of Mental Health Services in a Pediatric Care Clinic

Abstract

Depression is one of the most common mental health issues facing adolescents today. Screening for depression is recommended as part of well exams for adolescents in primary care, but screening alone is not enough. As with other chronic conditions, regular follow-up care is important. The purpose of this project was to improve the follow-up and coordination of mental health services for adolescents who screen positive for depression during well child visits in a pediatric primary care clinic. This quality improvement project utilized the Plan-Do-Study-Act model. Retrospective chart audits collected data on the use of the PHQ-9 depression screen and documentation of treatment, follow-up and referrals. Data collected guided the implementation of strategies to improve screening, provider documentation, and follow-up for adolescents with positive depression screens. Follow-up recommendations and provision of community resources were implemented as interventional strategies. Audit data reflected improvement in both PHQ-9 screening and follow-up documentation in those adolescents with positive screens. There are several implications for future practice. Continued evaluation of strategies implemented will confirm effectiveness. Additional strategies may be needed to ensure consistent follow-up for adolescents with positive depression screens. Methods utilized for follow-up included use of the patient portal. The development of additional strategies to enhance portal usage can improve the efficacy of portal use for communication and information.