title: Effect of routine mental health screening in a low-resource pediatric primary care population.
abstract: OBJECTIVE
  Despite evidence for its feasibility, the usage of mental health screening in primary care practices with overburdened providers and few referral options remains unclear. This study explores the effects of routine screening on mental health problem identification and management in a low-resource setting.
  
  
  METHODS
  Medical records of 5 to 12 year-old children presenting for well visits before and after screening was implemented were reviewed. Multivariate logistic regression was used to explore associations between study period and identification/management practices. Changes in the number of visits and wait times for a co-located referral service were assessed post hoc.
  
  
  RESULTS
  Parents disclosed more mental health problems, and providers initiated more workups but referred fewer patients after screening was implemented. The proportion of new visits and wait times for the referral service did not change.
  
  
  CONCLUSIONS
  Even in low-resource settings, screening may facilitate parental disclosure and increase clinical attention to mental health problems without overburdening referral services.
authors.affiliation: Department of Pediatrics, Division of General Pediatrics, Columbia University, New York, NY 10032, USA. eb283@columbia.edu
authors.forename: Evelyn
authors.initials: E
authors.lastname: Berger-Jenkins
authors.forename: Mary
authors.initials: M
authors.lastname: McCord
authors.forename: Trish
authors.initials: T
authors.lastname: Gallagher
authors.forename: Mark
authors.initials: M
authors.lastname: Olfson
mesh_terms: D002648:Child; D005260:Female; D006295:Health Resources; D006801:Humans; D016015:Logistic Models; D008297:Male; D008403:Mass Screening; D001523:Mental Disorders / Q000175:diagnosis* / Q000628:therapy; D015999:Multivariate Analysis; D010372:Pediatrics; D011320:Primary Health Care / Q000592:standards / Q000706:statistics & numerical data; D058996:Quality Improvement; D012017:Referral and Consultation / Q000706:statistics & numerical data; D012189:Retrospective Studies; D019037:Urban Health Services / Q000592:standards / Q000706:statistics & numerical data; D014850:Waiting Lists