VitalSign ⁶: Screening, Diagnosis, and Treatment of Depression for Adolescents Presenting to Pediatric Primary and Specialty Care Settings

Depression in youth is a critical public health concern. Nearly 13% of adolescents have experienced a depressive episode within the last year,¹ and suicide is the second leading cause of death among 15- to 24-year-olds.² Depression's negative impact spans several domains of functioning, leading to long-term effects on development.³ Recognizing the magnitude of the crisis, renewed guidelines by the US Preventive Services Taskforce and the American Academy of Pediatrics suggest that pediatric primary care providers become more active in the screening, diagnosis, and treatment of depression.^4,5 Primary care settings provide optimal opportunities to identify and treat depression, while reducing stigma and barriers surrounding mental health, particularly given the limited availability and cost of psychiatric specialists. Although providers cite difficulties, including insufficient appointment time, inadequate training, discomfort addressing mental health disorders, and stigma, the management of depressed patients is feasible and efficacious in primary care.^6-8 Several cost-efficient and easy-to-use depression screening tools are readily available and can be used alongside clinical interviews to diagnose and initiate treatment. In the following letter, we examine the feasibility of implementing a program focused on supporting pediatric providers in screening, diagnosing, and initiating depression treatment in youth.