It’s not in your HEADSS: Mental health screening in adolescent primary care visits.

BACKGROUND: Screening and surveillance of mental health concerns and risky behavior in primary care clinics leads to increased identification and treatment. Semi-structured examinations like the Home, Education, Activities, Drugs, Sex, Suicide (HEADSS) can aid medical providers in assessing topics such as suicidal ideation (SI) in youth. OBJECTIVE: This study aimed to assess the effectiveness of a quality improvement initiative aimed at increasing HEADSS documentation and its association with symptoms of depression and SI. METHOD: = 13.97) in a large pediatric primary care clinic. HEADSS administration was compared on demographics, Patient Health Questionnaire-9 Item Modified for Adolescents (PHQ-9A) score, and endorsed SI. Data were compared across two time points: 2017-2018 and 2022 (i.e., before and after a quality improvement intervention). HEADSS administration increased significantly from 31.1% in 2017-2018 to 58.5% in 2022, largely driven by a significant increase in any-HEADSS. Depression and endorsed SI were not related to HEADSS administration. CONCLUSION: Easy-to-use tools in the medical record led to increased documentation of HEADSS examinations. No association with PHQ-9A scores or SI was found, indicating that HEADSS were administered irrespective of symptoms of depression. However, HEADSS were administered at under 60% of visits, and additional research is needed to determine how to increase psychosocial and mental health screening to improve patient outcomes. (PsycInfo Database Record (c) 2026 APA, all rights reserved).