Abstract
The purpose of this project was to increase the number of mental health services based on the provided referral algorithm, in adolescents who have identified depressive symptoms. The Substance Abuse and Mental Health Services Administration (SAMHSA) and the World Health Organization (WHO) report that most teenage youths do not receive treatment, and the Centers for Disease Control and Prevention (CDC) recognizes poor access to mental healthcare providers as a contributing barrier (CDC, 2021; SAMHSA, 2019; WHO, 2020). The state of Missouri recognizes suicide as a clinical problem, while Healthy People 2030 and the United States Preventative Service Task Force (USPSTF) have implemented long-term goals to help address the risk of adolescent depression and suicide (Healthy People 2030, n.d.; USPSTF, 2016). This project was completed in a rural, public high school setting with a population focus on high school students. The implementation process consisted of four stages, modeled from the Kirkpatrick’s Four-level Training Evaluation Model; the pre-implementation, training, behavioral change, and results stage. Screeners participated in a 1-hour training session and successfully completed two mock depression screening utilizing the PHQ-A. A 16-week pilot program was conducted where screeners identified and referred participants with depressive symptoms to community mental health services utilizing the PHQ-A and referral algorithm. Two separate meetings were conducted post-pilot study with school stakeholders to evaluate program data, organizational changes, and future sustainability efforts. This project was successful in achieving the following project goals: 100% of the PHQ-A forms were completed correctly and appropriate referrals made per the referral algorithm; 100% of students who screened positive were referred to treatment;100% of the participant number, who screened positive for depressive symptoms, matched the increased number of new adolescent clients that were received within this timeframe at the referral locations. Three PHQ-A screenings were completed by the school counselor, and two of the identified participants required a mental health referral based on their PHQ-A score. Community mental health referrals increased from zero prior to the pilot program, to two referrals in high school students with identified depressive symptoms. Identified participants received community mental health services within one week utilizing the referral algorithm. Future studies would be beneficial to explore the value of annual PHQ-A depression screenings within public high school settings. There are opportunities to expand in-service training to all school employees on mental health stigma, benefit of depression screening within a public high school setting, common depression symptoms observed in the adolescent population.