Abstract
Early identification and treatment of depression during adolescence can contribute to healthier outcomes across the lifespan, yet adolescent depression has been underidentified and undertreated. The American Academy of Pediatrics’ (AAP) Guidelines for Adolescent Depression in Primary Care (GLAD-PC) were created to enhance the identification and treatment of adolescent depression. Integrated psychologists in a pediatric primary care setting partnered with providers and clinic staff to implement an adolescent depression screening initiative and transform primary care practice around identification and management. From January 2017 through August 2018, 2107 adolescents between the ages of 11 and 18 were screened using the PHQ-9A. Eleven percent (n = 226) of adolescents had an elevated screen with a score of ≥ 10 and 7% (n = 151) screened positive for suicidal ideation. Identification of depressive symptoms led to increased integrated behavioral health services delivered by psychologists, psychiatrists, and psychology trainees. Psychologists integrated in primary care can support primary care practices to develop service delivery systems aligned with AAP’s GLAD-PC and address the diverse implementation barriers associated with incorporating clinical practice guidelines in real-world settings. Universal screening for adolescent depression and response protocols were successfully implemented in a pediatric primary care clinic under the leadership of psychologists and pediatrician partners.
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This project was funded by Rose Community Foundation, The Colorado Health Foundation, and institutional support from the University of Colorado School of Medicine and Children’s Hospital Colorado.
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Lisa H. Costello, Christina Suh, Bridget Burnett, Kimberly Kelsay, Maya Bunik, and Ayelet Talmi declare that they have no conflict of interest.
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The project was approved by the Institutional Review Board at the University of Colorado and the Children’s Hospital Colorado Organizational Research Risk and Quality Improvement Review Panel. Analyses were conducted on de-identified data collected in the context of routine clinical care.
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Costello, L.H., Suh, C., Burnett, B. et al. Addressing Adolescent Depression in Primary Care: Building Capacity Through Psychologist and Pediatrician Partnership. J Clin Psychol Med Settings 28, 53–66 (2021). https://doi.org/10.1007/s10880-019-09680-w
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DOI: https://doi.org/10.1007/s10880-019-09680-w