At Children’s Hospital, ER visits offer opportunity to check on teens’ mental health


    When a physical injury sends an adolescent to the emergency room, doctors say that can be just the right time to check on a teen’s mental health.

    At the Children’s Hospital of Philadelphia, teens now complete a short computer survey when they show up in the ER.

    Joel Fein, co-director of the hospital’s Violence Prevention Initiative, said the goal is to get most adolescents to spend seven or eight minutes answering a computer-based questionnaire. That information then links directly to the patient’s digital health record.

    If the survey uncovers red flags that suggest emotional distress, a medical staffer steps in to ask more questions and give the patient additional support.

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    Drexel University psychologist Guy Diamond helped develop the screening tool at the Children’s Hospital. He says when you ask a teen, ‘Are you sad?’ or ‘Do you feel like hurting yourself?’ that adolescent may prefer to initially answer those questions on the computer instead of face-to-face with a doctor or nurse.

    “Even though they know they will have to talk about it later,” Diamond said.

    The hospital interviewed teens, parents and medical staff to develop the behavioral-health tool. Fein says one big concern among the adolescents was stigma.

    “They didn’t want to think that we were doing it on them and no one else. So we are making this universal,” Fein said.

    But the staff is still working to integrate the tool into the their workload. So far about 30 to 40 percent of patients complete the survey.

    The screener was designed to highlight mental health concerns, prevent suicide or violence.

    When a star athlete, who’d been sidelined by an injury, came in to the ER recently, “he told us he did feel like hurting himself,” Fein said.

    The hospital staff linked him with care in the community.

    “That would hopefully be able to keep him from becoming another emergency department patient later on,” Fein said.

    Nurses in the ER offer the screening tool to patients age 14 and older who are healthy enough to complete the survey.

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