[Structured Assessment of Mental Health Issues in Preventive Health Examinations - Findings from the...

BACKGROUND: Early detection of psychological problems is crucial to prevent chronic progression. The Psych-U study evaluated the added value of structured assessment of psychological issues during U-screenings compared to routine screenings without such assessment.

METHODS: In a cluster-randomized controlled design, a two-arm intervention group (IG; Strengths and Difficulties Questionnaire, SDQ, and Mannheimer Elternfragebogen, MEF) was compared to a control group (CG). In the IG, parents completed a tablet-based structured assessment of potential psychological issues before the U-screening, which was then discussed with pediatricians during the screening. Outcomes included acceptance (participation rate; parent phone interviews), feasibility (focus groups with practice teams), and effectiveness (referral rates) of the structured assessment versus routine care.

RESULTS: A total of N=3,138 families participated (participation rate: 85.3%). In parent phone interviews (n=348), the SDQ and MEF showed high acceptance. Focus group interviews with practice teams indicated high feasibility, but noted that implementing structured assessment into routine care would require systemic changes at the health system level (e.g., reimbursement for extra effort), practice level (e.g., digital data collection), and patient level (e.g., addressing language barriers). The IG had a higher referral rate than the CG.

CONCLUSION: Structured assessment of psychological issues appears beneficial but requires structural adjustments. Additionally, sufficient local referral options should be available.