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The Critical Role of Mental Health Assessment in Pediatrics: Depression and Suicide Risk

Updated: Mar 14

Pediatrics:  Depression and Suicide Risk
Depressed Teen

The rising prevalence of mental health issues, including depression and the risk of suicide, creates an urgent need for effective primary care screening and care strategies. Guidelines set by the American Academy of Pediatrics (AAP), the American Academy of Family Physicians (AAFP), and the American Psychological Association (APA), recognize these priorities in their recommendations. For example, the AAP recommends screening for depression in children 12 and up at least once per year, more often for teens who have a family history of depression, trauma, substance use, or adversity. Similarly, the AAFP guidelines recommend periodic screening for both depression and anxiety in adults. The National Institute for Mental Health now recommends a brief screening for suicidal ideation (ASSQ) for children 8 and up in all medical settings as suicide is not the leading cause of death starting at age 10.

Tools for Assessing Depression and Suicide Risk

There are many questionnaires available for screening for pediatric depression and suicide risk and monitoring status described below:

  • Patient Health Questionnaire (PHQ-9):

    • Assessment Focus: Evaluate the severity of depression symptoms.

    • Age Group: Adolescents (PHQ-A) and adults

    • Key Feature: 9 self-report questions covering DSM-IV depression criteria. Many versions are available with different cut scores, including or excluding questions about suicide as well as criteria for Major Depressive Disorder and Persistent Depressive Disorder.

  • Columbia-Suicide Severity Rating Scale (C-SSRS):

    • Assessment Focus: A clinician rating scales to assess the severity of suicidal ideation and behavior.

    • Age Group: all ages

    • Key Feature: Significant predictive validity and reliability in various settings.

  • Mood and Feelings Questionnaire (MFQ):

    • Assessment Focus: depressive symptoms in children and adolescents.

    • Age Group: versions for children 6-17 and for parents/caregivers.

    • Key Feature: Includes a broad range of depression symptoms, aligning with DSM criteria. No cut score but better for monitoring than PHQ-9.

  • Ask Suicide-Screening Questions (ASSQ):

    • Assessment Focus: Evaluate suicide-related thoughts and behaviors.

    • Age Group: Suitable for ages 8 and older.

    • Key Feature: A brief tool with four items, followed by a question asked by staff, if positive. Includes recommended follow-up assessment. Useful in all settings.

All of the above tools, and others screening for depression and suicidal ideation, are included in CHADIS. CHADIS also can provide the office with a report of all positives in case the patient does not come for the visit to facilitate follow-up.

CHADIS – Streamlining Mental Health Screening and Follow-Up

  • Automation in Screening:

    • Efficiency and Accuracy: CHADIS automates the distribution and scoring of mental health screening questionnaires, significantly reducing time and effort, and enhances the accuracy of the screening process.

    • Customizable Questionnaire Selection: With access to over 600 behavioral health and general health questionnaires, healthcare providers can set up an automated screening process and also allow manual assignment to meet the specific language and access needs of their patients, improving equity of care.

  • Streamlines Guideline-based Care

    • Patient-specific decision support: CHADIS Patient Specific Templates for care of depression and suicide risk provide decision support consistent with national GLAD-PC guidelines and Blueprint for Youth Suicide Risk Assessment including teleprompters for an assessment of depression, simplifies a structured suicide risk assessment,

    • Simplifies essential next steps in care: CHADIS provides a Safety Plan to complete with the youth and parent, a written care and emergency plan, a one-click referral system, schedules follow-up measures, and enables longitudinal tracking of patient outcomes.

  • Effective Follow-Up:

    • Timely Interventions: CHADIS’s system allows for real-time alerts and results, enabling healthcare providers to identify patients at risk promptly as needed for best care and timely interventions.

    • Patient Engagement: The platform encourages patient involvement in their own care, fostering a collaborative approach between patients and providers and automatically providing patient-specific handouts and resource listings.

  • Longitudinal Tracking Over Time:

    • Comprehensive Patient Histories: CHADIS’s integration with EHR systems provides a continuous record of patient screenings and outcomes. This feature allows for the creation of comprehensive patient histories, essential for monitoring progress and adjusting treatment plans.

    • Data-Driven Decisions: The accumulation of longitudinal data aids in making informed decisions based on trends and changes in a patient’s mental health status.

CHADIS not only streamlines the screening process for depression and suicide risk but also facilitates the follow-up and tracking of patients. Its integration with major Electronics Health Records, combined with its extensive range of tools, positions CHADIS as a vital resource in modern healthcare, particularly in enhancing mental health assessments and interventions.

To learn more about how CHADIS can empower your practice, click here to schedule a short demonstration.


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