Virtual clinic program increased mental health screening for teens

TEAMSS was a quality-improvement collaborative, meaning it was designed to help clinics improve how they deliver care. It was not described as a trial comparing the program with another approach.

The project engaged 160 clinicians at 27 pediatric primary care clinics across 18 states. Its focus was routine care for adolescents ages 12 to 18. Clinics worked on screening and follow-up for substance use, depression, anxiety, and suicide risk.

The program adapted a learning-collaborative model for virtual participation. Clinics took part in learning sessions and action periods, with individualized coaching between sessions. The aim was to help busy primary care teams put screening and follow-up into their usual workflows.

According to the study abstract, clinics standardized their screening and intervention processes, used validated screening tools, and increased use of electronic health records and mobile devices for screening. They also involved more members of the care team, identified community resources, and increased staff knowledge of evidence-based guidelines and quality-improvement methods.

The reported changes were largest for substance-use and anxiety screening. Substance-use screening increased from 35% to 75%. Follow-up for adolescents who had a positive substance-use screen increased from 69% to 86%.

Depression screening rose from 82% to 90%. Anxiety screening increased from 32% to 69%. Screening for suicide risk increased from 18% to 41%.

These numbers describe changes in the participating clinics’ reported screening and follow-up practices. The abstract calls the increases in substance-use screening and follow-up significant. It does not provide details on the number of adolescents screened, how the percentages were calculated, or the statistical testing for the other measures.

The results are encouraging because screening is a first step toward recognizing concerns that might otherwise be missed during routine visits. But screening is not the same as a diagnosis, treatment, or better health outcome. The supplied study information does not report whether adolescents’ symptoms, substance use, safety, or longer-term well-being improved.

It also does not describe a comparison group of clinics that did not take part. That makes it difficult to know how much of the change came specifically from TEAMSS rather than other changes occurring at the same time. The study does not say which parts of the program mattered most, or whether results would be the same in clinics with different staffing or resources.

The news coverage reports that, nine months after the collaborative ended, 85% of clinics said they had fully maintained the changes they made. That suggests the new workflows may have lasted beyond the project, though this was clinic-reported information rather than a measure of patient outcomes.

Future research would need to examine whether these systems lead to timely, effective support for adolescents and better health outcomes. It would also need to clarify how the approach works across different primary care settings.