Implementing Screening and Counseling for Adolescent Mental Health and Substance Use

Area of Science:

• Pediatric Health
• Implementation Science
• Public Health

Background:

• Adolescent mental health and substance use disorders (MHSUD) are increasing.
• Pediatricians face barriers to implementing evidence-based screening and counseling for MHSUD.
• Primary care settings are crucial for early identification and intervention.

Purpose of the Study:

• To systematically review the effectiveness of implementation strategies for integrating MHSUD screening and counseling into pediatric primary care.
• To assess activities that enhance implementation, service, and health outcomes related to MHSUD care.

Main Methods:

• Systematic review of literature published since 2010.
• Included studies compared implementation strategies for MHSUD interventions in primary care for individuals ≤18 years.
• Data extraction covered study designs, interventions, barriers, facilitators, and outcomes.

Main Results:

• Eleven studies examined implementation of screening and counseling for depression, eating disorders, substance use disorders, and behavioral health risks.
• Multifaceted approaches included integrating behavioral health providers, learning collaboratives, clinician support, and technology.
• These strategies generally increased screening, follow-up actions, and treatment initiation compared to minimal or no strategy.

Conclusions:

• Multifaceted implementation approaches show promise for improving MHSUD identification and management in primary care.
• Limited evidence on patient outcomes and study overlap restricts definitive conclusions.
• Further research is needed to strengthen the evidence base for effective MHSUD implementation strategies.