A Clinical Care Algorithmic Toolkit for Promoting Screening and Next-Level Assessment of Pediatric Depression and Anxiety in Primary Care

J Pediatr Health Care. May-Jun 2017;31(3):e15-e23. doi: 10.1016/j.pedhc.2017.01.008. Epub 2017 Mar 22.


With a documented shortage in youth mental health services, pediatric primary care (PPC) providers face increased pressure to enhance their capacity to identify and manage common mental health problems among youth, such as anxiety and depression. Because 90% of U.S. youth regularly see a PPC provider, the primary care setting is well positioned to serve as a key access point for early identification, service provision, and connection to mental health services. In the context of task shifting, we evaluated a quality improvement project designed to assist PPC providers in overcoming barriers to practice-wide mental health screening through implementing paper and computer-assisted clinical care algorithms. PPC providers were fairly successful at changing practice to better address mental health concerns when equipped with screening tools that included family mental health histories, next-level actions, and referral options. Task shifting is a promising strategy to enhance mental health services, particularly when guided by computer-assisted algorithms.

Keywords: Anxiety; depression; mental health; pediatric primary care; screening; task shifting.

Publication types

  • Multicenter Study

MeSH terms

  • Adolescent
  • Adolescent Health Services* / trends
  • Algorithms*
  • Anxiety / diagnosis*
  • Child
  • Child Guidance
  • Child Health Services* / trends
  • Depression / diagnosis*
  • Female
  • Health Promotion*
  • Humans
  • Male
  • Mass Screening / statistics & numerical data*
  • New England
  • Primary Health Care / statistics & numerical data*
  • Primary Health Care / trends
  • Quality Improvement
  • Referral and Consultation
  • Workforce