Preventing suicide among adolescents: Barriers to mental health screening by primary care providers
Abstract
Objective: The purpose of this study was to identify primary care providers' (family practitioners, pediatricians, internal medicine physicians, gynecologists, and advanced practice nurses) screening practices for suicide and mental health problems in adolescents (under the age of 25) and factors that serve as barriers or facilitators for screening. Design: This study utilized a cross-sectional design with data collection occurring online through the Qualtrics survey software. The survey contained questions regarding primary care provider demographics, patient demographics, current screening practices, barriers to screening, and interest in attending future workshops related to mental health screening among adolescents. Primary care providers over the age of 18 were eligible for inclusion in this study. The data were analyzed using SPSS (version 19) and STATA to examine significant relationships between provider and patient demographic characteristics, current screening practices, and barriers and facilitators to screening. Setting/Subjects: The study was conducted in three regions in the state of Indiana. Physicians in Allen County on the Fort Wayne Medical Society list-serve, advanced practice nurses at Purdue University North Central clinic and primary care providers employed through Indiana University Health Arnett via employment directories were recruited to participate. Results: The sample in this study (n=43) was heterogeneous in regards to sex, race, specialty, and type of practice. Geographical settings including urban, rural, and suburban also were represented. There was a significant difference in screening for suicide between male and female providers. 57.1% of female providers frequently screened for suicide versus 15.0% of male providers. Providers seeing more patients under age 25 were more likely to screen for mental health. Providers who saw more African American patients were less likely to screen for mental health in their practices. In addition, providers were more likely to screen if they believed more strongly that behavioral health was congruent with their philosophical approach to medicine. Providers who reported not having enough time to screen for suicide when screening for mental health were less likely to screen for mental health. Conclusions: While additional research with a larger sample is warranted to ensure a representative sampling of physicians, these preliminary findings suggest factors to consider when developing programs to support increased primary care provider screening for suicide and mental health among adolescents. In particular, it appears that workshops aimed at delivering adequate knowledge and training regarding adolescent suicide risk assessment to providers would be well received by providers in the future.
Degree
M.P.H.
Advisors
Lyle, Purdue University.
Subject Area
Mental health|Public health
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