title: Pediatric emergency medicine physicians' current practices and beliefs regarding mental health screening.
abstract: BACKGROUND
  Only 20% of children with mental health issues are identified and receiving appropriate treatment nationally. The emergency department (ED) may represent a significant opportunity to provide selective pediatric mental health screening to an at-risk population.
  
  
  OBJECTIVE
  To describe the current standard of care and perceived limitations among pediatric emergency medicine (PEM) physicians regarding mental health screening.
  
  
  METHODS
  A 23-question survey on screening practices for pediatric mental illness (PMI) was sent to PEM physician participants identified through the American Academy of Pediatrics Section on Emergency Medicine mailing list.
  
  
  RESULTS
  Of the 576 physicians meeting our inclusion criteria, 384 (67%) surveys were returned. Eighty-six percent of respondents indicated screening for PMI in 10% or less of their eligible patients. Overall, 43% of respondents indicated screening only if the chief complaint was psychiatric in nature. The remaining 217 physicians most commonly screened for depression (83%), suicidality (76%), and substance abuse (67%). Only 9% of physicians stated that they used evidence-based medicine in determining their screening practices. Women physicians (odds ratio, 1.94; 95% confident interval, 1.08-3.47) and those using evidence-based medicine (odds ratio, 3.88; 95% confidence interval, 1.92-7.85) were more likely to conduct screening. Significant limitations to screening identified by respondents include the following: time limitations (93%), absence of a validated screening tool (62%), limited resources (46%), and lack of training (44%). Eighty-eight percent of physicians believe that a validated and standardized screening tool would improve their ability to identify PMI.
  
  
  CONCLUSIONS
  Routine PMI screening is conducted infrequently by most PEM physicians. Improved physician education/training and the development of a validated ED-specific mental health screening tool would assist PEM physicians in the early detection of PMI.
authors.affiliation: Division of Pediatric Emergency Medicine, Children's Memorial at Central Dupage Hospital, Northwestern University Feinberg School of Medicine, Winfield, IL 60190, USA. Arie_Habis@cdh.org
authors.forename: Arie
authors.initials: A
authors.lastname: Habis
authors.forename: Lori
authors.initials: L
authors.lastname: Tall
authors.forename: Julien
authors.initials: J
authors.lastname: Smith
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Guenther
mesh_terms: D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D004635:Emergency Medicine / Q000706:statistics & numerical data*; D005260:Female; D019538:Health Care Surveys; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000706:statistics & numerical data*; D001523:Mental Disorders / Q000175:diagnosis*; D008875:Middle Aged; D010372:Pediatrics / Q000706:statistics & numerical data*; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D013406:Suicide, Attempted / Q000517:prevention & control; D014481:United States