Protecting Adolescents’ Mental Health with Screenings

Doc Talk: Tips & Advice 

If your child is 12 or older and you visit the Emergency Department at Children’s Hospital Los Angeles with a medical issue, you’ll likely be asked to leave the room for 2-3 minutes so the doctor can administer a mental-health screening. Dr. Alan Nager shares about the program he created.

When and why did you begin these screenings?

About four years ago. The American Academy of Pediatrics suggests emergency departments and pediatricians’ offices conduct them.

Adolescents are at greatest risk for mental health issues. Depression in girls ages 12-15 has tripled in the last 10-15 years and approximately 20 percent of 9-17-year-olds have a diagnosable mental or addictive disorder. And if you leave these issues untreated, they get worse.

How do parents react?

Most are OK with it. A lot of parents deal with levels of impairment and think their kids will outgrow it. Some have been noticing symptoms for years, but think it is just normal adolescent behavior. Everyone knows adolescents are challenging because they are independent, curious, mischievous and risk taking. They are also secretive, and this makes it difficult for parents to know when there is a problem.

What are the questions about?

There are 10 yes-or-no questions. We ask about drinking and drug use, feelings of depression and anxiety, physical and sexual abuse, suicidal thoughts or thoughts of harming others, bullying and domestic violence, among other issues. If a child answers “yes” to one of our questions, we bring in a social worker to talk with them and connect the family with help.

What types of issues have you uncovered?

In our study of 1,000 patients, 34 percent reported feeling depressed, 20 percent reported anxiety and 6 percent reported suicidal thoughts or thoughts of hurting themselves or others. We also had kids tell us about bullying, physical and sexual abuse.

If we addressed mental health in the same way we address physical health, we would catch these issues much sooner. Parents with concerns should contact their pediatricians about mental-health screening for their kids.

Alan L. Nager, M.D., M.H.A., has been Director of Emergency and Transport Medicine at Children’s Hospital Los Angeles for 18 years, and is a professor of Pediatrics at the Keck School of Medicine of the University of Southern California.