Abstract
Purpose: To implement and evaluate a screening and referral process for adolescents with anxiety in the primary care setting as a quality improvement (QI) project.|Background: Anxiety in adolescents is one of the most common mental health conditions; most are underdiagnosed and untreated. Symptoms from anxiety can interfere with an adolescent’s daily life and milestones. Primary care providers are encouraged to screen all adolescents for mental health concerns at well-child visits; however, adolescents are not routinely screened for anxiety in the primary care setting, and standardized screening guidelines do not exist. Screening for anxiety may help facilitate early identification and referral for adolescents in need of mental health services.|Sample/Setting: The setting was a family medicine practice in the Midwest. The sample included 18 English speaking/reading adolescents aged 11-21.|Methods: Adolescents were screened during well visit examinations using the Generalized Anxiety Disorder-7 (GAD-7). An algorithm was utilized to determine the need for education, treatment and/or referral based on the screening score. Data was analyzed using descriptive statistics.|Results: Eighteen GAD-7 screenings were performed in adolescents (N=18, Mean age =15) with scores ranging from 0 to 17. A total of 61.1% of participants had positive screenings (mild to severe); 22% of participants received a referral; 22% of participants were prescribed medication.|Conclusion: This QI project demonstrates and supports the feasibility of using the GAD-7 with a screening algorithm for adolescents in the primary care setting. The GAD-7 screening tool with a screening algorithm would assist in changing practice to better address anxiety in adolescents.