Addressing Adolescent Depression in the Primary Care Setting

Recently, teenagers have experienced numerous stressors. As a result of the coronavirus and global unrest, they have had to shelter in place, miss graduations and proms, witness racial injustice and mass protests, and maintain social distancing during summer vacation. In addition, their families and other supportive individuals may be experiencing reduced income due to job loss or may have contracted or died from COVID-19. These factors, in addition to any existing depression risks (history of previous episodes, family history, other psychiatric disorders, substance abuse, trauma, or psychosocial adversity), may place your adolescent patients at increased risk for depression.

Guidelines for Depression Screening

Research shows that 20% of teenagers have had depression at some point during adolescence, and point prevalence rates can be as high as 28% in the primary care office.* In order to address the high rates of adolescent depression in the primary care office, a North American collaborative has developed guidelines to assist primary care providers (PCPs). Their recommendations include:

• Depression screening
• Active monitoring of mildly depressed youth
• Treatment of moderate and/or severe depression with evidence-based medication and psychotherapy
• Close monitoring of medication side effects.
• Consultation and co-management of care with mental health specialists.
• Ongoing tracking of outcomes, and specific interventions for partial or no response after initial treatment

Referral and Training Resources for PCPs

CDPHP is committed to helping you identify, triage, treat, and coordinate care for teens with depression or other mental health issues, so we’ve made the following resources available to our primary care practitioners: 

Valera Health is a virtual mental health practice, available to CDPHP members, that is staffed by adult and child/adolescent psychiatrists, psychopharmacologists, and therapists. Referrals can be made directly from the primary care office, by contacting the CDPHP Behavioral Health Access Center, or by patient self-referral.

Project Teach is a free program for prescribers who treat children and youth in New York State. Services include live and online training in child and adolescent mental health, free continuing medical education, and free consultations with child and adolescent psychiatrists 

* Zuckerbrot, RA et al, Guidelines for Adolescent Depression in Primary Care (GLAD-PC): Part I. Practice Preparation, Identification, Assessment, and Initial Management. Pediatrics March 2018, 141 (3).