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Feature

ADOLESCENT WELL-CARE: Surveillance and Screening

Community Care of North Carolina and Community Care Partners of Greater Mecklenburg

There are two assessments that are components of the adolescent well-visit — and both are recommended in the NC 2018 Health Check Program Guide.

 STRENGTHS AND RISKS:                                                             DEPRESSION:

  Bright Futures Fourth Edition emphasizes a strengths-based approach              Both Bright Futures and the USPSTF (U.S. Preventive Services Task
at all well-visits and recommends a psychosocial assessment at all               Force) recommend routinely screening adolescents for depression starting
well-visits. In the early years of the NC CHIPRA Grant, a survey of              at age 12. Depressive symptoms and depression itself are common in
adolescents across the state regarding their health care, revealed that being    adolescents (depression—up to 6 percent; 20 percent will have at least one
asked about what was going well and goals for the future is a priority           episode of major depression before age 18). Additionally, suicide is the
for adolescents (not just being asked about what is going wrong). For            second leading cause of death of youth ages 10-17.
adolescents, assessing for risks and strengths is a key part of the well-visit.
                                                                                 Tools: PHQ-2/PHQ-9 Modified for Adolescents. To assess for suicidality
Tools: Bright Futures Supplemental Adolescent Questionnaires,                    – SAFE-T (Suicide Assessment Five-step Evaluation and Triage), SBQ-R
the RAAPS (Rapid Assessment for Adolescent Preventive Services),                 (Suicide Behaviors Questionnaire-Revised), SIQ (Suicidal Ideation
and HEADSSS.                                                                     Questionnaire).

Coding: 96160 – health risk assessment                                           Coding: 96127

  See the CCNC Pediatrics: Adolescent Depression: Screening, Follow-up and Co-management Guidelines for an office process
algorithm. The toolkit also contains information on SSRI use in pediatric primary care, and on referral to, and communication with, mental health
professionals. Find the guidelines at https://www.communitycarenc.org/sites/default/files/2018-01/adolescent-depression-toolkit-april-2017.pdf.

Reading as an Anxiety and
  Depression Prescription

     The Smithsonian Institute, Huffington Post and Boston Globe suggest
        that reading is an excellent way to reduce stress. A study from the
           University of Sussex found that reading for pleasure can reduce

       stress up to 68 percent. Want to relax? Here are some suggestions:

                                  Read something for fun.
                                Read about topics you enjoy.
                          Read articles or books on your hobbies.

Want to know more? Here are a few links to explore:

www.smithsonianmag.com/smart-news/doctors-are-now-prescribing-books-to-treat-depression-180948211/
www.huffingtonpost.com/healthline-/five-ways-reading-can-imp_b_12456962.html
nationalreadingcampaign.ca/wp-content/uploads/2013/09/ReadingFacts1.pdf
www.takingcharge.csh.umn.edu/reading-stress-relief

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