Screening for Behavioral Health Issues in Primary Care
Purpose of review
Over the past several decades, pediatricians and other primary care providers have recognized the need for greater implementation of screening for emotional and behavioral health (BH) problems, yet only a minority screen for BH issues.
We summarized guidelines from Bright Futures/American Academy of Pediatrics (AAP), the US Preventive Services Task Force (USPSTF), and the AAP Task Force on Mental Health (TFOMH) regarding screening for BH disorders in the pediatric primary care setting. We provide information on validated screening tools that a pediatrician might use in practice, listed by age range. We also present the recent literature on screening for behavioral health issues in primary care focusing on screening initiatives and their impact, models of screening, feasibility, and clinician and caregiver attitudes.
We recommend that pediatricians develop a process to implement general BH screening, as well as targeted screening for specific disorders, according to the guidelines. Although initiatives have resulted in increased screening, children are still missed. Initiatives are variable in how they report clinical outcomes with many but not all reporting increases in identification and referral. More research is needed on how to best implement BH screening in primary care and how to ensure that it positively impacts BH assessment and treatment in primary and BH specialty care.
KeywordsBehavioral health Mental health Guidelines Primary care Screening Integrated care
We would like to thank Moshe Kupferstein DO, Gaurav Vishnoi, MD and Rachel Waxman, MD for their thoughtful comments and contributions.
Compliance with Ethical Standards
Conflict of interest
Jessy Joseph and Faisal Kagadkar declare no conflict of interest.
Cathryn A. Galanter is a faculty member and on the steering committee of the Patient-Centered Mental Health in Pediatric Primary Care of the Resource for Advancing Children’s Health (REACH) Institute. She has received royalties from the American Psychiatric Publishing.
Human and animal rights and informed consent
This article does not contain any studies with human or animal subjects performed by any of the authors.
References and Recommended Reading
Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance
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