Name
Chamberlain University
NR-505: Advanced Research Methods: Evidence-Based Practice
Prof. Name
Date
One of the most pressing issues in nurse practitioner (NP) practice is mental health screening in primary care settings. Mental health disorders, particularly depression and anxiety, are among the leading contributors to disability and decreased quality of life worldwide. In the United States alone, approximately 17.3 million adults (7.1% of the population) experience at least one major depressive episode annually (National Institute of Mental Health [NIMH], 2017). Despite this prevalence, routine screening is often overlooked due to stigma, time constraints, and limited resources, resulting in delayed diagnoses and poor outcomes (Aci et al., 2018).
To address this issue, I recommend implementing annual depression and anxiety screenings for all patients during their primary care visits. Standardized tools such as the Patient Health Questionnaire (PHQ-9 for adults and PHQ-A for adolescents) can be used to identify early signs of mental health conditions. Early detection allows NPs to initiate timely treatment, improve symptom management, and reduce the long-term burden of untreated illness. Evidence demonstrates that consistent screening not only enhances diagnostic accuracy but also lowers suicide risk, promotes individualized treatment plans, and increases overall patient satisfaction (Geyti et al., 2018; Chamberlain University, 2021). This shift toward evidence-based screening practices ensures that patients receive proactive, holistic care that addresses both their physical and psychological needs.
Integrating depression and anxiety screening into primary care is strongly aligned with evidence-based practice (EBP). EBP emphasizes delivering the most current, research-supported interventions to maximize patient outcomes. By incorporating standardized screening protocols, NPs can significantly improve diagnostic timeliness, treatment initiation, and long-term health outcomes (Chamberlain University, 2021).
The impact of such screening can be summarized in the following table:
| Area of Impact | Expected Outcomes |
|---|---|
| Early Identification | Increased detection of depression and anxiety at early stages |
| Patient Outcomes | Improved quality of life, reduced symptom severity, and lower suicide risk |
| Provider-Patient Relationship | Stronger trust and communication through proactive and individualized care |
| Healthcare System Benefits | Reduced healthcare costs through timely interventions and prevention of severe illness |
By implementing mental health screening at least once a year, NPs can foster a culture of preventive care that addresses both physical and emotional well-being.
To integrate this intervention into practice, I would utilize the Patient Health Questionnaire-9 (PHQ-9) for adults and the PHQ-A for adolescents aged 12–17. These tools are validated and reliable for identifying depressive symptoms. A score of 10 or greater typically indicates a positive screen, which requires further evaluation and discussion with the patient (Maurer et al., 2018).
Every patient would undergo screening at least annually, but if additional concerns arise, more frequent assessments could be conducted. Outcome measurement would involve tracking the number of positive versus negative screens, noting patients who received new diagnoses without prior mental health history. Importantly, a positive screen would necessitate a documented follow-up plan that could include medication, therapy, or a referral to a mental health specialist (Savoy, 2016).
The table below illustrates the structured screening and follow-up process:
| Step | Description |
|---|---|
| Screening Tool | PHQ-9 for adults; PHQ-A for adolescents |
| Screening Frequency | At least once annually; more often if concerns are raised |
| Criteria for Positive Screen | Score of ≥10 |
| Follow-up Interventions | Therapy, pharmacological treatment, or specialist referral documented same day |
| Outcome Measurement | Monitoring number of positive/negative tests and tracking new diagnoses |
Thorough documentation ensures that treatment progress is monitored, outcomes are measured, and care is continuously improved based on patient needs.
Your point about adolescent mental health is very important. Depression and anxiety in children and teenagers are often overlooked due to misconceptions such as the belief that “children have nothing to be stressed about.” However, research indicates that 10.3% of children in the U.S. are diagnosed with depression or anxiety, and the number continues to rise (Centers for Disease Control and Prevention [CDC], 2021).
Children and adolescents face immense pressures, including academic expectations, extracurricular commitments, part-time jobs, and social challenges. These stressors can contribute to significant emotional distress. Unfortunately, many children are adept at masking symptoms, which leads to underdiagnosis. For this reason, I agree that routine screenings should be part of yearly check-ups and sports physicals, regardless of whether concerns are raised.
By incorporating standardized tools like PHQ-A during pediatric visits, NPs can uncover hidden struggles and provide interventions earlier. Early recognition and treatment can significantly alter a young person’s developmental trajectory, preventing worsening symptoms into adulthood.
Aci, M., Zhang, S., Chomanczuk, A. H., O’Brian, K. H., De Zitella, M. L. M., Scrifanim, P. R., Velez, L., Garay, E., Sezer, S., Little, V., Cleek, A., & McKay, M. M. (2018). Barriers and facilitators to mental health screening efforts for families in pediatric primary care. Journal of Family Social Work, 21(3), 191–199. https://doi.org/10.1080/10522158.2018.1429212
Centers for Disease Control and Prevention (CDC). (2021). Data and statistics on children’s mental health. https://www.cdc.gov/childrensmentalhealth/data.html
Chamberlain University. (2021, September 1). Week 1 lesson: Evidence-based practice. https://chamberlain.instructure.com/courses/87542/pages/week-1-research-evidence-based-practice-and-quality-improvement
Geyti, C., Dalsgaard, E., Sandbæk, A., Maindal, H. T., & Christensen, K. P. (2018). Initiation and cessation of mental healthcare after mental health screening in primary care: A prospective cohort study. BMC Family Practice, 19(1), 1–8. https://doi.org/10.1186/s12875-018-0864-9
Maurer, M. M., Raymond, T. J., & Davis, B. N. (2018). Depression: Screening and diagnosis. American Family Physician, 98(8), 508–515.
National Institute of Mental Health. (2017). Major depression. https://www.nimh.nih.gov/health/statistics/major-depression
Savoy, M. (2016). Screening your adult patients for depression. Family Practice Management, 23(2), 16–20.
