The Value of Mental Health Screening for Adolescents Attending School-Based Health Centers

Elizabeth R. Pulgaron, N. D. W. Smith, Mira Armans, Jennifer Coto, M. Maurer, Lisa Gwynn
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Abstract

Although 65% of school-based health centers (SBHCs) offer mental health services, at-risk youth are commonly overlooked or do not follow up when referrals are made. Universal screenings may increase identification of those in need of mental health support. We examined the number of youth at three SBHCs referred for mental health consultations. Comparisons were made between provider referrals and those with elevated scores on the Youth Pediatric Symptom Checklist-17 (Y-PSC-17). Of the 585 patients in this study, 37 (6.32%) were referred solely by their Y-PSC-17 score, 36 (6.15%) youth were singularly referred by providers, and 19 (3.25%) were referred by both modalities. Almost three-quarters ( n = 67; 72.8%) of identified youth elected to receive psychotherapeutic services. Approximately half of the youth referred by providers ( n = 19; 52.8%) received individual services, while 36.11% ( n = 13) received group services. Smaller proportions of youth with elevated Y-PSC-17 scores received individual ( n = 7; 18.9%) and group services ( n = 11; 29.7%). Youth referred solely by a medical provider had significantly lower scores than those identified through an elevated Y-PSC-17 score. Findings highlight the necessity of universal screening in pediatric settings in addition to physician referrals to provide a supplemental layer of prevention and early identification of behavioral health concerns. In this study, 40% referrals would have been missed if both modalities were not in place. Educating medical providers on youth mental health concerns may enhance identification of those in need of mental health supports and in turn improve long-term outcomes.
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校本健康中心青少年心理健康筛查的价值
虽然65%的校本保健中心(shhcs)提供心理健康服务,但有风险的青少年通常被忽视,或者在转诊时没有跟进。普遍筛查可增加对需要精神卫生支持的人的识别。我们调查了三家青少年健康中心转介心理健康咨询的人数。比较提供者转诊和青少年儿科症状检查表-17 (Y-PSC-17)得分较高的患者。在本研究的585例患者中,37例(6.32%)仅通过Y-PSC-17评分转诊,36例(6.15%)由提供者单独转诊,19例(3.25%)通过两种方式转诊。几乎四分之三(n = 67;72.8%)选择接受心理治疗服务。大约一半的青年由提供者转介(n = 19;接受个人服务的占52.8%,接受团体服务的占36.11% (n = 13)。Y-PSC-17得分较高的青少年接受单独治疗的比例较小(n = 7;18.9%)和团体服务(n = 11;29.7%)。仅由医疗提供者转诊的青少年的得分明显低于通过Y-PSC-17得分升高确定的青少年。研究结果强调,除了医生转诊外,在儿科环境中进行普遍筛查的必要性,以提供预防和早期识别行为健康问题的补充层。在这项研究中,如果两种方式都不到位,40%的转诊会被错过。就青少年心理健康问题对医疗服务提供者进行教育,可以加强对需要心理健康支持的人的识别,从而改善长期结果。
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