Universal Mental Health Screening in Teens at BullDoc Health Clinic – A Quality Improvement Project

Introduction.Wyandotte county is ranked 104 th out of 104 counties in Kansas with regards to health outcomes.Student health is the leading factor impacting mental stability and school-wide success for high schoolers in Wyandotte county.BullDoc Health Clinic is a free clinic embedded within Wyandotte High School.Our goal is to improve access to healthcare for students so they can be healthier, happier, and more successful in school.The purpose of this project was to implement a structured mental health screening process to increase identification of teenagers with mental health disorders and refer them to the school's social workers for treatment.Methods.We conducted an observation period of five weeks, then began screening every patient with the Patient Health Questionnaire-Modified for Teens (PHQ-A) for several weeks.After nine weeks, we began screening patients with a history of a traumatic event with the UCLA 9-Item Trauma Screen in addition to the PHQ-A.Data was collected via a RedCap ® survey completed by student-physicians and analyzed with Wilcoxon rank sum in Matlab ® (Version 3). Results. Patients who scored higher on screening tests were more often referred to social workers (p< 0.05).Additionally, this project identified other reasons for elevated PHQ-A scores, aside from underlying depression, such as lack of access to corrective lenses or housing insecurity.Conclusions.This led to the development of a new leadership position, Director of Community Resources.Future directions include improving optometry resources, providing patients with hygiene products to take home, and continuing to screen for mental illness.