Quality of mental health care for depressed adolescents.
Understanding the quality of routine care for adolescent depression constitutes the initial step in designing and implementing improvement strategies. This study assessed depression detection and type and duration of services for adolescents in mental health care settings. Medical record diagnosis and standardized research interview results were compared for youth seeking mental health treatment. The majority of depressed adolescents received care consistent with guidelines and evidence. However, only 51% received appropriate medication; fewer than half received at least 8 sessions of outpatient care or follow-up after hospitalization. Males received significantly fewer components of quality care compared with females. Depression diagnoses in routine care may be facilitated by using structured interviews or questionnaires. Quality monitoring and improvement initiatives may also increase rates of care components that are consistent with guidelines and evidence. Methods tested in this study may facilitate the evaluation of quality improvement initiatives for adolescent depression or other mental health disorders.
Kramer
Teresa L
TL
Division of Health Services Research, Department of Psychiatry, University of Arkansas for Medical Sciences, Little Rock, AR 72204, USA. KramerTeresaL@uams.edu
Miller
Terri L
TL
Phillips
Susan D
SD
Robbins
James M
JM
D000293:Adolescent; D000928:Antidepressive Agents / Q000627:therapeutic use*; D003866:Depressive Disorder / Q000175:diagnosis* / Q000188:drug therapy* / Q000208:ethnology; D019263:Dysthymic Disorder / Q000175:diagnosis / Q000188:drug therapy / Q000208:ethnology; D005260:Female; D019983:Guideline Adherence; D006801:Humans; D008297:Male; D008605:Mental Health Services / Q000458:organization & administration*; D017410:Practice Guidelines as Topic; D011785:Quality Assurance, Health Care / Q000458:organization & administration*; D012111:Residence Characteristics / Q000706:statistics & numerical data; D019966:Substance-Related Disorders; D013405:Suicide
D000928:Antidepressive Agents