Adolescent Mental Health in Primary Care: A Needs Assessment for Improving Practice

Abstract

Background: Youth and young adults have the highest incidence and prevalence of mental health issues, and most do not receive the services they need. Mental health is an essential component of wellness, and primary care providers (PCPs) serve a critical role in promoting mental well-being, identifying problems, facilitating and coordinating services, and managing and monitoring mental health outcomes. Many barriers exist to incorporating mental health into routine primary care for adolescents, and little is known about the specific nature of the obstacles that impede the quality improvement process related to integrating mental and physical health and how to overcome them. Objectives: The purpose of this DNP project was to gain insight into the PCP role, exploring perceptions, current practices, and barriers related to screening, identifying, and managing adolescent mental health needs, understand the challenges and opportunities, and guide future quality improvement projects that reflect and respond to the needs of adolescents in the local community in effective and sustainable ways. Methods: The project was designed as a needs assessment, and conducted as an anonymous 20 question survey that was distributed to 13 local PCPs that routinely provide primary care services to the community’s adolescent population. Results: Nine of the surveys were completed and returned. Time constraints and competing demands were dominant concepts, reported as primary barriers to screening, collaboration with mental health professionals, and addressing mental health in general. The participants articulated the need for high-quality professional mental health involvement, improved collaboration, inter-professional development, and inter-agency cooperation to successfully promote mental health and provide excellent care that improves outcomes. They also displayed an interest in innovative solutions and organizational restructuring to better coordinate mental health services. Conclusion: This project offered preliminary insight into the challenges faced by PCPs addressing adolescent mental health in primary care, and generated ideas for further exploration to guide quality improvement initiatives designed to support the providers' capacity to incorporate mental health into routine care, and contribute to the community’s efforts in promoting mental health for local youth. PCPs occupy esteemed roles in the community, and their perspectives and insight are invaluable.