Journal of the American Academy of Child & Adolescent Psychiatry
ReviewUniversal Mental Health Screening in Pediatric Primary Care: A Systematic Review
Section snippets
Search Strategy
PubMed, PsycInfo, and EMBASE were searched for studies of universal mental health screening in pediatric primary care in developed countries. A research librarian and an expert in systematic reviews were consulted on database selection and search term development. Terms were identified using each database's controlled vocabulary and other key words within 4 domains: mental health, children, primary care, and screening. Three authors (K.F., L.W., and R.Z.) came to consensus on the final terms
Results
Initial searches produced 1,263 titles of possible relevance (Figure 1). Of these, we screened the 1,188 unique titles and abstracts. Review of these titles and abstracts, plus searches for articles possibly related to those found to be in range, resulted in a preliminary review of 186 full-text articles. The final narrative synthesis included 45 articles describing 38 studies. The most common reasons for exclusion after full-text review were that the article was a review article without
Discussion
For mental health screening to succeed, respondents must be willing to divulge potentially sensitive information and agree to its meaning and validity. This review found that current use in primary care, at least as reflected in the contents of published reports, places little emphasis on steps that would make this possible. Published reports give little explanation of how the purpose of screening is explained or what youth are told about who will have access to the information. Assistance with
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This article is discussed in an editorial by Dr. Michael S. Jellinek on page 1131.
Clinical guidance is available at the end of this article.
This work was supported by the National Institute of Mental Health (NIMH) grant P20 MH 086048.
The authors gratefully acknowledge the guidance of Andrea Villanti, Ph.D., and Donna Hesson, M.L.S., of the Johns Hopkins School of Public Health for guidance with systematic literature review methods.
Disclosure: Drs. Wissow, Brown, Fothergill, Gadomski, Hacker, and Salmon, and Ms. Zelkowitz report no biomedical financial interests or potential conflicts of interest.