Screening for Depression at Adolescent Well-Child Visits: Who Is Screened and What Happens Afterward?

To evaluate the frequency of depression screenings administered at yearly adolescent well visits between 2019 and 2022 and to examine how often primary care providers initiated a depression-related follow-up action for youth who screened "high" for depression.

We examined electronic health record data between 2019 and 2022 for youth patients aged 12-17 years (N = 53 283) at Advocate Health‑Midwest. Depression screening and related data were collected from each patient's index well visit, and depression-related follow-up data were collected within the first 6 months after the index well visit.

Depression screenings were completed at 86.7% of well visits, and patients who were screened were more likely to receive follow-up care compared with those who were not (adjusted OR, 1.33; 95% CI, 4.56-5.87). Significant differences in depression screening rates and follow-up care were observed based on age, race and ethnicity, and insurance type.

Depression screening rates were high year-over-year, which may be attributed to the automated depression screening system embedded within the health care system's electronic health record. There is still a need to improve equity in screening practices, particularly for historically marginalized groups, as screening for depression is a crucial step in connecting at-risk youth with follow-up care.