Doctors are encouraged to offer mental-health screening for teens

Screening teenagers for mental illness should become routine in doctor’s offices nationwide, experts from the nonprofit program TeenScreen said Thursday.

Under the federal healthcare reform legislation, mental-health screening is listed as a free, preventive-care service. So far, about 1,500 primary-care doctors nationwide are offering the screening -- usually a short list of questions. However, many doctors may be reluctant to implement screening due to the time it takes, because they won’t be reimbursed for the service or because they lack knowledge on how to implement a screening program, experts said.

But screening can be accomplished in a busy pediatric or primary-care doctor’s office, said Dr. Magally Prosper, a pediatrician in Brooklyn, N.Y.

“It’s have been very helpful to me, in my practice, to identify kids in crisis,” she said in a Webinar conducted Thursday by TeenScreen. “I’m a pediatrician. I have a responsibility to my patients and their families to identify problems before they escalate.”

The need to address mental illness in children and teens is clear, said Christina Carro Newport, program manager of the TeenScreen National Center at Columbia University. About 11% of children and teens have mental illness that causes impairment, but only a small percentage are diagnosed and receive treatment. Suicide is the third leading cause of death for children age 11 to 18.

“Half of all lifetime mental-health disorders start by the age of 14,” Newport said. “There really is a window of opportunity for prevention in most cases... When you offer routine screening you will find teens you were not aware of who are having difficulties. Screening gives these patients a voice... the ones who are having difficulty will tell you.”

If doctors identify a problem, the teen can be referred for further evaluation and treatment or the doctor can make an appointment to see the teen again to further discuss the issue. Suicidal teens can be referred for immediate care, Prosper said.

Doctors may worry about false-positives, according to experts. But a discussion with the patient should clarify if the teen needs a referral to a mental-health specialist. The tool is a screen and is not meant to diagnose specific problems.

The TeenScreen National Center for Mental Health Checkups at Columbia University offers a variety of resources to promote screening in practice nationwide.

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