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Screening tool identified mental health issues among adolescents presenting to ED

An 11-item mental health screening tool successfully detected alcohol/drug abuse, traumatic exposure and maladaptive behavioral symptoms among adolescents and young adults who presented to the ED with medical complaints.

“It is estimated that depression rates in girls, aged 12 to 15 years, have tripled in the last 10 to 15 years. In the United States, 9.5% to 14.2% of children, between birth and 5 years, have social-emotional problems. Approximately 21% of children and adolescents between 9 and 17 years have a diagnosable mental or addictive disorder associated with at least minimum impairment,” Alan L. Nager, MD, MHA, of the Children’s Hospital Los Angeles and Keck School of Medicine at the University of Southern California, and colleagues wrote. “Yet, in any given year, it is estimated that about 1 in 5 children receives mental health services. The prevalence of mental health conditions in children and adolescents necessitates the development of effective screening tools to uncover emotional, behavioral, or psychiatric concerns. Screening for mental health conditions should lead to an appropriate assessment and early intervention.”

Alan L. Nager

Researchers developed the Emergency Department Distress Response Screener (ED-DRS), an 11-item mental health screener to detect the prevalence of alcohol/drug abuse, traumatic exposure and behavioral symptoms in adolescents and young adults presenting to the pediatric ED for medical complaints. They applied the ED-DRS to 992 patients (mean age, 15.11 ± 2.1 years) who presented to the ED.

Symptomatic patients responded “yes” to at least one ED-DRS item while asymptomatic patients answered “no” to all items.

Overall, 47.5% of the study cohort was symptomatic and 52.5% were asymptomatic.

Alcohol/drug abuse was detected among 14% of symptomatic patients.

Regarding traumatic exposure, physical or emotional trauma was detected among 33.5% of symptomatic patients; bullying among 29.3%; physical abuse among 21.2%; inappropriate touching among 8.1%; and domestic violence among 7%.

Regarding behavioral symptoms, depressed mood was detected among 33.8% of symptomatic patients; anxiety among 30.4%; high energy behavior among 23.8%; hallucinations among 6.6%; and suicidal/homicidal ideation among 6.2%.

“Although patients present to the ED with medical complaints, they may also be at risk for mental health problems. The ED-DRS was able to identify among an adolescent and young adult population evidence of alcohol/drug abuse, [traumatic exposure], and maladaptive [behavioral symptoms]. The ED may be an ideal setting that could regularly implement mental health screening to provide early intervention and treatment,” the researchers concluded. – by Amanda Oldt

Disclosure: The researchers report no relevant financial disclosures.