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Mental Health Screening Tool Tested in Children's Hospital Emergency Department

In a study published on October 1 in the journal Pediatric Emergency Care, investigators at Children's Hospital Los Angeles (CHLA) piloted a brief mental health screening tool to be used with patients accessing the emergency department for medical complaints who might be at risk for mental health problems. Of the 992 patients studied, nearly one-half (47.5%) responded "yes" to questions about substance abuse, traumatic exposure, or behavioral symptoms such as depression and anxiety.

In the U.S., 1 in 10 children and adolescents suffer from mental illness; yet only 1 in 5 receive mental health services. Many undiagnosed mental health conditions can lead to chronic medical conditions that interfere with a child's normal development and functioning.

"Based on recommendations from organizations, literature and research, it is becoming clear that identifying mental health needs is part of quality medical care," says Alan L. Nager, MD, MHA, director of Emergency and Transport Medicine at Children's Hospital Los Angeles and first author on the study. "The emergency department is the ideal place for that assessment to occur." Nager is also professor of Clinical Pediatrics at the Keck School of Medicine of University of Southern California (USC).

This retrospective study was based on a previous quality improvement project that assessed mental health issues among English-speaking patients, 12 years of age or older. Physicians conducted interviews in the privacy of the patient's room, without parent or caregiver present. Patients were asked to answer 11 yes/no questions that covered a range of mental health issues including hyperactivity, exposure to domestic violence, drug and alcohol use, bullying, and thoughts of suicide.

"By embedding mental health screening in the emergency department, we are making it part of our health care culture—reducing the stigma associated with mental health problems and providing the opportunity for early identification and treatment for all children," says Jeffrey I. Gold, PhD, director of the Children's Outcomes, Research and Evaluation program at CHLA and an author on the study. Gold is also an associate professor in Anesthesiology and Pediatrics at the Keck School of Medicine of USC.

Source: Children's Hospital Los Angeles