Screening for Parental Depression in Urban Primary Care Practices: A Mixed Methods Study

Area of Science:

• Pediatric Health
• Mental Health Screening
• Public Health

Background:

• Parental depression significantly impacts child development and family well-being.
• Integrating mental health screening into routine pediatric care is crucial for early intervention.

Purpose of the Study:

• To assess the feasibility and acceptability of parental depression screening in urban pediatric settings.
• To identify barriers and facilitators influencing the implementation of depression screening for parents.

Main Methods:

• A prospective study involving seven urban pediatric practices.
• Utilized the Patient Health Questionnaire-2 (PHQ-2) for screening at well-child visits for 1-3 year olds.
• Conducted semi-structured interviews with clinicians to explore implementation challenges and successes.

Main Results:

• Screening was completed by 21.1% of 8,621 eligible parents, with significant site-to-site variation (10.1%-48.5%).
• 8.1% of screened parents tested positive for depressive symptoms, with rates varying by practice (1.2%-16.9%).
• Electronic alerts substantially increased screening rates from 45 to 170 per month.

Conclusions:

• Parental depression screening is feasible in pediatric practices, with clinician support for its benefits.
• Key barriers include time constraints, competing priorities, limited mental health resources, and challenges serving non-English speaking parents.
• Strategies to enhance screening uptake and address barriers are needed for effective implementation.