Kite Insights

How Routine Depression Screenings Can Help Protect Kids

At Rady Children’s Hospital-San Diego, we believe in managing care for the whole child, which includes both their physical and mental health. While you can often see when children are suffering from an injury or illness, the signs of a serious mental health condition are often more difficult to pinpoint — especially in kids and teens who may be “expected” to go through emotional changes as part of growing up, or who may not be open to discussing their feelings with caregivers.

However, mental illnesses such as depression and anxiety are not things that one can simply grow out of, and mental health is a very real and significant issue for adolescents. For example

  • the Rady Children’s emergency department sees between 300 and 400 patients in psychological distress each month;
  • nearly 6 percent of youth ages 12 to 17 have depression[1];
  • about 75 percent of kids ages 3 to 17 years with depression also have anxiety, and about 50 percent also have behavioral problems[2];
  • diagnosis rates for anxiety or depression in kids ages 6 to 17 increased from 5.4 percent in 2003 to 8.4 percent in 2011 – 20122; and
  • depressed adolescents are at an increased risk for suicide[3].

Treating mental health conditions is possible, and early identification and intervention are key to helping kids find professional help and begin a care plan that works for their unique needs. Accordingly, and given the expanding prevalence of mental health disorders in youth, organizations including the American Academy of Pediatrics, the American Academy of Family Physicians and the United States Preventive Services Task Force recommend all kids age 12 and older receive depression screenings at medical appointments[4],[5]. The AAP also published new teen depression guidelines in 2018 — the first update in a decade — to support doctors in developing an appropriate care plan with patients and their caregivers. Lead author Amy Cheung, MD, stated, “We would like to see teens fill out a depression screening tool as a routine part of their regular wellness visits. Parents should be comfortable offering any of their own observations, questions or concerns, which will help the physician get a well-rounded picture of the patient’s health.” The guidelines also aid physicians in determining when steps need to be taken to partner with mental health experts for patient care.

Using evidence-based standards and tools from these and additional professional organizations, Rady Children’s maintains a depression screening program for all patients 12 and up. Screenings happen in both inpatient and outpatient settings, and are conducted every 30 days if a child returns for care. Based on a patient’s results, providers may refer patients to appropriate resources within Rady Children’s or in the community, or determine the need to transfer the child to the Hospital’s emergency department for further assessment. Plans for the program began in late 2015, and required extensive collaboration throughout the organization to bring it from concept to reality.

The Centers for Disease Control and Prevention reports that suicide is the second most common cause of death in individuals ages 10 to 34[6]. This staggering statistic makes the depression screening program, as well as its ongoing evolution, all the more important. “Our goal is to help make sure every child we see who may benefit from mental health care and support receives it,” explains Jacqueline Small, LCSW, a Rady Children’s medical social worker and a leader in rolling the depression screening program out to patients. Between April 2016 and October 2018, Rady Children’s staff completed about 80,000 screenings; approximately five percent of which flagged patients to be at risk for moderate or severe depression. “Our staff is very dedicated to not just screening, but to doing something with the results. By asking these important questions, we are saving lives,” Small adds.

Rady Children’s is committed to further expanding this program, examining outcomes and increasing access to mental health care for youth in our community. Along with the depression screening initiative, we offer a number of inpatient and outpatient services in mental and behavioral health, and look forward to opening our region’s first-ever pediatric psychiatric emergency department.

Some mental health resources available to the community are outlined below. If you feel your child is an immediate danger to themselves or others, please call 911 or take them to the closest emergency room right away.

  • 211 San Diego: Call 211 from mobile phone or 858-300-1211, or visit www.211sandiego.org
  • Crisis Text Line: Text HOME to 741741 to text with a trained crisis counselor or visit www.crisistextline.org
  • Imperial County Mental Health Crisis Hotline: Call 800-817-5292
  • National Alliance on Mental Illness San Diego Helpline: Call 800-523-5933 or visit www.namisandiego.org
  • National Suicide Prevention Lifeline: Call 800-273-8255
  • Psychiatric Emergency Response Team (PERT): Call 911 or your local police department
  • Rady Children’s Behavioral Health Urgent Care: Call 858-966-5484
  • Riverside County HELPLine: Call 951-686-4357
  • San Diego County 24-Hour Emergency Access and Crisis Line: Call 888-724-7240, or visit www.optumsandiego.com or www.up2sd.org
  • SmartCare Behavioral Health Consultation Service: Call 858-956-5901, visit www.smartcarebhcs.org or email bhcs@vistahill.org

[1] https://www.cdc.gov/nchs/products/databriefs/db172.htm

[2] https://www.cdc.gov/childrensmentalhealth/data.html

[3] https://www.healthychildren.org/English/health-issues/conditions/emotional-problems/Pages/Which-Kids-are-at-Highest-Risk-for-Suicide.aspx

[4] https://www.aap.org/en-us/about-the-aap/aap-press-room/Pages/AAP-Publishes-Teen-Depression-Guidelines.aspx

[5] https://www.aafp.org/afp/2018/1015/p508.html

[6] https://www.cdc.gov/nchs/products/databriefs/db330.htm