Graduation Year

2024

Degree Type

Open Access Capstone

Document Type

Capstone

Degree Name

Doctor of Nursing Practice (DNP)

Department

Baccalaureate and Graduate Nursing

First Advisor

Fontaine Sands

Department Affiliation

Nursing

Second Advisor

Brooke Bentley

Department Affiliation

Nursing

Abstract

Adolescent depression is becoming increasingly prevalent in the United States with an estimated 2.9 million adolescents between the ages of 12 and 18 years old affected by Major Depressive Disorder annually. Adolescent depression increases the risk of academic difficulties, substance abuse, and suicide. Depression screening in the primary care setting is an effective intervention to identify at-risk youth, but screening rates remain low. Primary care providers fail to identify up to 80% of adolescents with depression symptoms and more than 60% of adolescents do not receive needed mental health services. This DNP project implemented an evidence-based practice change for annual depression screening in the adolescent population during well-child visits in the primary care setting to improve identification of adolescents with depression and the initiation of appropriate mental health referrals. The Patient Health Questionnaire (PHQ-9) is a validated, reliable screening tool for depression and was the screening tool of choice for the quality improvement project. During the DNP project, provider knowledge and confidence in the use of the PHQ-9 in the adolescent population increased, depression screening in the adolescent population was implemented, and access to needed mental health referrals was improved for at-risk adolescents. Further interventions are needed to improve the accuracy of transcription of the PHQ-9 into the electronic health record and compliance with in-house counseling appointments.

Keywords: adolescent, depression, screening, treatment, referrals, specialists, usual care.

IRB Approval Number (if applicable)

6010

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