I started using TeenScreen materials in 2009 after learning about the program through Kaiser Permanente Southern Colorado. Previously, I based my mental health assessment of patients on what I termed as the “hunch technique” – essentially using my gut to determine whether the child/adolescent may have a mental health disorder. I would ask a few questions, use my knowledge of that child and their family, and make a quick assessment. However, once we started regularly using the TeenScreen screening tools in practice. I realized that the “hunch technique” missed some who may have been suffering with depression or another mental illness.
For example, I had a 12-year-old patient that I had been seeing since infancy and know that she comes from a well-functioning family. Her mother brought her in because she noticed that she had been sleeping a lot. One of her hobbies was writing music, and lately, she hadn’t been able to finish a song. My staff gave her a screen (the PSC-Y) to fill out in the waiting room and much to my surprise, she checked ‘yes’ to the suicide ideation question. During the examination, I learned that her older sister – with whom she was very close – was about to leave for college. She felt all alone and was losing hope. In addition, she was having trouble in school. We treated her for depression and further assessment revealed that she was dyslexic, which she was treated for as well. So in addition to revealing her depression and suicide ideation, the screen helped us determine that she also had a learning disability.
Another patient, a 14-year-old boy, came to see me with a minor sports injury. As is our standard practice, my staff gave him a screen (the PSC-Y) in the waiting room – and he checked ‘yes’ to thinking about suicide. I spoke to him about this and learned that he was drinking alcohol and smoking marijuana every day. And most disturbing, he had a precise suicide plan – he was very serious about it. I immediately referred him to a nearby therapist and he has been in therapy for more than a year now. As of our last appointment, he had stopped drinking and smoking marijuana. For me, this case again reinforced the value of screening: to find a very serious problem that is unrelated to the reason for the office visit.
As pediatricians, we see our adolescent patients just once a year – if we’re lucky – in our practices. And in this brief visit, we get only a quick flash into their life. Without the TeenScreen screening questionnaires, we’re missing opportunities. The screens save time and make communication more efficient. Having the answers to a screen helps direct conversations to the important points at hand. The questionnaires are easy to give – and teenagers seem to feel comfortable answering the questions because they’re given in a non-threatening manner (a self-report questionnaire filled out in the waiting room). There’s no one sitting across the table from them. And the fact that they’re confidential is something that my patients and their parents really appreciate.