Do the Guidelines for Adolescent Preventive Services (GAPS) Facilitate Mental Health Diagnosis?

Details

• Personal Author:
  Gadomski AM ; Jenkins PL ; Krupa N ; Scribani MB
• Description:
  Objective: To determine if the Guidelines for Adolescent Preventive Services (GAPS) increases detection or shortens time to diagnosis of mental health (MH) disorders, particularly adolescent depression. Methods: Starting in May 1999, GAPS questionnaires were routinely administered at adolescent annual visits at 1 primary care clinic in a rural health network. Using an administrative database, we enumerated all MH diagnostic codes for outpatient visits of adolescents aged 13 to 15 years. Population based rates were derived using school enrollment data. Using time series, the rates of MH diagnoses were compared pre- and post-GAPS. Using survival analysis, the time to any MH diagnosis subsequent to index annual visits was also compared pre- and post-GAPS. Because the GAPS questionnaire includes questions for depressed mood, anhedonia, and suicidality, ICD-9-CM codes for depression and mood disorder were also analyzed separately. Results: Time series analysis included 8112 adolescents. The rate of MH diagnosis did not change pre- and post-GAPS (P = .13). Time to any MH diagnosis was similar pre-GAPS (9.0 months) and post-GAPS (7.0 months, log rank P = .30). Time to any first diagnosis of depression or mood disorder was similar post-GAPS (12.2 months) versus pre-GAPS (11.0 months, log rank P = .34). Conclusions: Use of the GAPS was not associated with change in the rate of or time to MH diagnosis. Our results challenge the prevalent expectation that requiring mental health screening will reduce unmet need for MH treatment. Validated MH screening tools, primary care provider training, and access to MH services may also be needed but further study is required. [Description provided by NIOSH]
• Subjects:
  Adolescent Diagnosis Health Promotion Mental Health Nervous System Occupational Health Preventive Medicine Safety Surveys And Questionnaires
• Keywords:
  Adolescents Author Keywords: Primary Care Children Diagnostic Techniques Health Communications Mental Health Pediatrics Preventive Medicine Quality Improvement Questionnaires Rural Health Screening Programs Teenagers

  More +
• ISSN:
  2150-1319
• Document Type:
  Text
• Funding:
  Cooperative Agreement
• Genre:
  Journal Article
• Place as Subject:
  New York ; OSHA Region 2
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Pages in Document:
  85-89
• Volume:
  5
• Issue:
  2
• NIOSHTIC Number:
  nn:20053074
• Citation:
  J Prim Care Community Health 2014 Apr; 5(2):85-89
• Contact Point Address:
  Anne M. Gadomski, Bassett Medical Center, One Atwell Road, Cooperstown, NY 13326, USA
• Email:
  anne.gadomski@bassett.org
• Federal Fiscal Year:
  2014
• NORA Priority Area:
  Agriculture, Forestry and Fishing
• Performing Organization:
  Mary Imogene Bassett Hospital, Cooperstown, New York
• Peer Reviewed:
  True
• Start Date:
  20010930
• Source Full Name:
  Journal of Primary Care and Community Health
• End Date:
  20270831
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:10853efd8691c095e26e327c59854a7e92135ca9192e381593a8165f683ed571a12c76acdee15e44effcc6e47c688b829bf332f3ce37dc84f75bc7e8ac8eba08
• Download URL:
  https://stacks.cdc.gov/view/cdc/215918/cdc_215918_DS1.pdf
• File Type:
  [PDF - 141.14 KB ]