Screening for Depression at Adolescent Well-Child Visits: Who Is Screened and What Happens Afterwards?

Abstract

To evaluate the frequency in which depression screenings were administered at yearly adolescent well visits between 2019 - 2022, and to examine how often primary care providers initiated a depression-related follow-up action for youth who screened "high" for depression. We examined electronic health record (EHR) data between 2019 - 2022 for youth patients ages 12 - 17 (N = 53,283) at Advocate Health - Midwest. Depression screening and related data were collected from each patient's index well visit, and depression-related follow-up data were collected within the first 6 months after the index well visit. Depression screenings were completed at 86.7% of well visits, and patients who were screened were more likely to receive follow-up care compared with those who were not (adjusted OR = 1.33, 95% CI [4.56, 5.87]). There were significant differences in depression screening rates and follow-up care, based on age, race and ethnicity, and insurance type. Depression screening rates were high year-over-year, which may be attributed to the automated depression screening system embedded within the healthcare system's EHR. There is still a need to improve the equity of screening practices, particularly for historically marginalized groups, as screening for depression is a crucial step in connecting at-risk youth with follow-up care.