Feasibility and effects of a web-based adolescent psychiatric assessment administered by clinical staff in the pediatric emergency department.

Objectives  To determine the adoption rate of the Web-based Behavioral Health Screening–Emergency Department (BHS-ED) system during routine clinical practice in a pediatric ED, and to assess this system’s effect on identification and assessment of psychiatric problems.

Design  Descriptive design to evaluate the feasibility of a clinical innovation.

Setting  The ED of an urban tertiary care children’s hospital.

Participants  Adolescents from 14 to 18 years of age, without acute or critical injuries or illness, presenting with nonpsychiatric symptoms.

Intervention  The ED clinical staff initiated the use of the BHS-ED system, which identifies and assesses adolescents for depression, suicidal ideation, posttraumatic stress, substance use, and exposure to violence. Treating clinicians reviewed results and followed routine care practices thereafter.

Main Outcome Measures  Adoption rate of the BHS-ED system by nursing staff, identification rates of occult psychiatric problems, and social worker or psychiatrist assessment. Data were collected for 19 months before implementation of the BHS-ED system and for 9 months during implementation.

Conclusions  In a busy pediatric ED, computerized, self-administered adolescent behavioral health screening can be incorporated into routine clinical practice. This can lead to small but significant increases in the identification of unrecognized psychiatric problems.

Contact us for a copy of this article, or view online at http://jamanetwork.com/journals/jamapediatrics/fullarticle/384018