Pediatric Behavioral Health Screening in the Primary Care Practice

Abstract

Behavioral health issues affect between 15% to 20% of children, and if left untreated, these issues can lead to long-term mental and physical health issues in children and adolescents. The purpose of this quasi-experimental, evidence-based quality improvement project was to evaluate the efficacy of the Pediatric Behavioral Health Screen in identifying mental health concerns and functional ability impairments in pediatric patients between the ages of 7-18 years seen in the pediatric primary care clinic and the referral rate to mental health services for those that screen positive for concerns. The intervention and retrospective chart review was conducted over four months; between January 2022 and April 2022, there were 86 participants in each of the two cohorts, intervention and retrospective. The intervention participants were current patients that presented to the clinic for their annual well-child exam. The screening tool identified that 25.6% of patients had positive Internalizing Domains, 29.1% had positive Attention Domains, and 8.1% had positive Externalizing Domains. There were 16.3% of participants screened positive for functional impairments. While 52.3% of participants identified some level of functional impairment concern, their scores did not meet the positive screen threshold. The retrospective cohort anxiety identification rate was 22%, and the depression identification rate was 25.6%. The intervention cohort referral rate was 22.1%, an increase of 110% over the retrospective cohort. With the significant number of pediatric patients currently affected by mental health issues, early identification and referral to appropriate services will improve their long-term physical and mental health.