Effect of routine mental health screening in a low-resource pediatric primary care population

Area of Science:

• Pediatric Primary Care
• Mental Health Services Research
• Public Health

Background:

• Mental health screening in primary care is feasible but its impact in low-resource settings with provider limitations is unclear.
• Understanding the effects of routine screening on identification and management of pediatric mental health issues is crucial.

Purpose of the Study:

• To explore the impact of routine mental health screening on the identification and management of mental health problems in children within a low-resource primary care setting.
• To assess changes in parental disclosure, provider workups, referral rates, and referral service wait times following the implementation of mental health screening.

Main Methods:

• A retrospective review of medical records for children aged 5-12 years was conducted, comparing periods before and after screening implementation.
• Multivariate logistic regression analyzed associations between the study period and mental health identification/management practices.
• Post hoc analysis examined changes in visit numbers and wait times for a co-located referral service.

Main Results:

• Implementation of mental health screening led to increased parental disclosure of mental health problems.
• Providers initiated more workups for mental health concerns but referred fewer patients after screening.
• No significant changes were observed in the proportion of new visits or wait times for the referral service.

Conclusions:

• Routine mental health screening in primary care can enhance parental disclosure and clinical attention to mental health issues in children.
• The findings suggest that screening is effective even in resource-limited environments without overwhelming existing referral services.