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TeenScreen Physician Advisor |
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Professional Guidance for Implementing Mental Health Checkups in Primary Care Practice
| John H. Genrich, M.D.Physician Advisor
Colorado Pediatrician |
Questions & Answers Dr. John Genrich, TeenScreen Physician Advisor, answers primary care providers’ questions about offering mental health checkups in their primary care practices.
To submit a question for Dr. Genrich, e-mail
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Q: What systems are necessary for primary care providers to have in place to begin to implement mental health checkups in their office?
A: Physicians and primary care providers cite the need for more education about mental health symptoms and diagnosis, reimbursement assistance, and an efficient system of referrals as challenges that can delay or prevent them from offering mental health checkups to their adolescent patients. The good news is that these needs can be met.
Resources Available
At present, there are resources available to:
- guide providers in offering mental health checkups as part of regular office visits
- assist with obtaining reimbursement for screening, and
- suggest a best practice approach to establishing a mental health evaluation referral network.
According to the U.S. Preventive Services Task Force, the nation’s leading independent panel of experts in prevention and primary care, there are accurate screens available for detection of mental health disorders in adolescents as well as effective treatments for major depressive disorder in this population. Multiple evidence-based screening tools are currently available for physicians to aide them in implementing mental health checkups as a regular standard of care.
There’s an app for that…
The Agency for Healthcare Research and Quality (AHRQ), the nation’s lead federal agency for research on health care quality, costs, outcomes and patient safety, offers an Electronic Preventative Services application that is downloadable for iphones, BlackBerrys, personal digital assistants (PDAs), and via the Web which provides links to USPSTF screening recommendations for adolescents and screening tools. To download this application visit: http://epss.ahrq.gov/PDA/index.jsp.
TeenScreen Primary Care Tools
The TeenScreen Primary Care program can provide physicians and other primary care professionals with free mental health screening questionnaires, as well as an easy-to-read Pocket Guide to Mental Health Checkups, which gives instruction on screen administration and scoring and information and tips on referral and reimbursement.
To receive free screening questionnaires and a copy of the Pocket Guide to Mental Health Checkups for Primary Care Providers, visit: http://www.teenscreen.org/teenscreen-primary-care.
Getting Started: Offering Mental Health Checkups In The Primary Care Office
The first thing physicians can do is to develop a plan to integrate
mental health checkups into their office flow. They should talk to
office staff and think about a private area where adolescents may
complete the brief mental health questionnaire while they are waiting
to see their doctor or provider. Also to be discussed is how physicians
will review the results before seeing patients for their physical exam
and where the questionnaires will be placed in the patient’s
confidential medical file.
Suicide hotline numbers and emergency referral information should be
readily available in case the screening evaluation shows there is an
emergent need to refer the patient for immediate mental health
services.
Office staff should be trained to facilitate these steps into a typical
adolescent health visit and be able to appropriately answer questions
from patients and parents. TeenScreen Primary Care offers information
in its materials on how to best communicate about mental health
screening and appropriate follow-up with teens and their parents.
The Pocket Guide to Mental Health Checkups for Primary Care Providers
provides tips on setting up a referral network and the availability of
reimbursement codes for mental health checkups.
Addressing these key components will help to make the integration of
mental health checkups in primary care a seamless transition and assure
that adolescents in need receive appropriate evaluation and follow-up
care.
An Office Checklist:
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Have you determined a referral network in your local area?
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Do you have contact information at your fingertips for medical services in case a patient is at risk for suicide?
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Are you and is your office staff up to speed on how to talk to
patient families about the screening questionnaire and what it is for?
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Have you reviewed the scoring instructions so that you feel
comfortable scoring the questionnaire and interpreting the results?
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Do you have the reimbursement codes for time spent with the
patient after the screening questionnaire is filled out and reviewed?
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Have you determined how you will file the questionnaires and
whether you will offer the screening to a particular age group? Have
you considered if you will offer the screen annually?
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Are you prepared to talk with your patients about the screen,
especially if the screen endorses some symptoms of depression or
another mental health disorder?
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Programs & Initiatives 