Implementation of Universal Adolescent Depression Screening: Quality Improvement Outcomes

Introduction: Despite the increasing incidence of adolescent depression, suicide and evidence-based recommendations for adolescent depression screening, 70% of teens report not discussing depression with their provider. The aim of this quality improvement project was to improve the identification and management of adolescent depression by implementing a practice-based, universal depression screening. Method: The Patient Health Questionnaire-9 modified for Adolescents was implemented during annual wellness visits for adolescents aged 12-18 years over 3 months. Retrospective chart reviews were conducted to determine a change in the rates of depression screening, depression diagnoses, referrals to mental health, and pharmaceutical treatment of depression. Results: Pre/postimplementation data were compared. Documented adolescent depression screening increased from 0% to 74.5%. Increased rates of diagnosed depression ( 12.1%), mental health referrals (8%), and pharmaceutical treatment of depression (4.9%) were clinically and statistically significant. Discussion: Adopting evidence-based recommendations for universal depression screening in pediatric primary care can improve the early diagnosis and management of adolescent depression.