Abstract
Purpose: According to the World Health Organization, anxiety is the sixth leading cause of illness and disability in those ages 10-14. The purpose of this quality improvement pilot project was to educate staff of a middle school on the signs and symptoms of adolescent anxiety and to implement a consistent anxiety referral protocol including identification of enhanced access and role of the school nurse.|Background: Anxiety is a mental health condition of significance in early adolescence and is a major cause for school health office visits. School nurses have a vital role in identifying and providing student families with referral information for increased access to mental health care. The COVID-19 pandemic has resulted in the need for increased adolescent mental health care.|Sample/Setting: Sample data was obtained from students and staff within a midwestern urban middle school. Staff respondents were blinded to the project leader for pretest and posttest data. Student data was deidentified prior to the project leader’s receipt of data.|Methods: Three staff educational sessions were provided on anxiety and the pilot project protocol. Pretests and posttests were used to assess staff perception and understanding. The school nurse recorded data and provided the project leader with deidentified quantitative data after pilot period completion. After the pilot period, de-identified data was collected from the school’s electronic medical record (EMR) system to examine prepandemic data from November 2019 and intrapandemic data from November 2021.|Results: Quantitative data gathered from the school’s EMR revealed 16.2% of health office visits during the piloted period in 2021 were classified by the health office staff under anxiety symptoms, compared to 11.7% during the same month period in 2019.|Conclusion: Research is needed on standardized adolescent mental health assessment and referral tools within schools. Consideration of school staff barriers, education, and comfort level with mental health referral could be examined.|Keywords: adolescent, anxiety, screening tool, assessment, referral, COVID-19, pandemic