Abstract
Background: Adolescent depression and suicide are critical public health concerns in the United States. Approximately 20% of youth aged 12–17 experience a major depressive episode annually, yet fewer than half receive treatment (NIMH, 2023). Suicide is a leading cause of death among adolescents and young adults (CDC, 2023). The U.S. Preventive Services Task Force (USPSTF) recommends screening for major depressive disorder (MDD) in adolescents aged 12–18 when adequate systems are in place for diagnosis, treatment, and follow-up, but concludes that evidence is insufficient to recommend routine suicide risk screening in children and adolescents (USPSTF, 2022).
Purpose: This literature review evaluates whether implementing nurse-led, universal depression and suicide risk screening using validated tools (such as the PHQ-9-A and PHQ-2 with suicide-risk follow-up) with a standardized referral pathway in pediatric primary care improves identification, referral, follow-up, and documentation of adolescent mental health concerns compared with current inconsistent approaches.
Methods: A structured literature review was conducted using PubMed, CINAHL, Cochrane Library, PsycINFO, and Google Scholar databases. Studies published between 2013 and 2025 involving adolescents aged 12–18 in primary care or school-based settings were included. The review was guided by the PRISMA 2020 framework to ensure systematic and transparent evidence appraisal.
Results: Evidence from a large school-based randomized clinical trial indicates that universal PHQ-9 screening increases identification of depressive symptoms and increases the likelihood of initiating recommended services compared with targeted referral (Sekhar et al., 2021). However, an updated systematic review found no eligible controlled studies that isolate the benefits and harms of depression screening in pediatric primary care or other nonmental health clinical settings (Beck et al., 2024). Across the evidence base, screening programs show the greatest potential impact when paired with standardized referral pathways, timely follow-up, and safety protocols for positive suicide-risk items.
Conclusion: Nurse-led, standardized depression screening when paired with structured suicide risk assessment for positive screens and a clear referral and follow-up pathway is a promising approach to im-prove early identification and linkage to care. Implementation should be supported by robust diagnostic, treatment, and crisis-response systems, and further pragmatic trials in pediatric primary care are needed to clarify effects on clinical outcomes.
Sigma Membership
Non-member
Type
Other
Format Type
Text-based Document
Study Design/Type
Literature Review
Research Approach
Translational Research/Evidence-based Practice
Keywords:
Adolescent Depression, Depression in Adolescence, Mental Depression, Suicide Risk Screening, Diagnosis of Mental Depression, Suicide Prevention, Medical Screening, PHQ-9, Patient Health Questionnaire-9, Questionnaires, Nurse-Led Screening, Pediatric Primary Care, Pediatrics, Primary Care, Mental Health Referral, Medical Referrals, Universal Screening, Evidence-Based Practice, Evidence-Based Medicine
Advisor
Charity M. Chimwala-Selico
Degree
Master's
Degree Grantor
Charles R. Drew University of Medicine and Science
Degree Year
2026
Recommended Citation
Hewitt, Malu-Kanoa; Morris, Briana; Ukpong, Dolly; Teklehaimanot, Lula; Singh, Preet Kamal; Scott, Latasha; and Chimwala-Selico, Charity Msamalia, "The Impact of Nurse-Led Universal Depression and Suicide Risk Screening on Adolescent Mental Health Outcomes in Pediatric Primary Care" (2026). General Submissions: Clinical Settings Materials. 58.
https://www.sigmarepository.org/gen_sub_csm/58
Rights Holder
All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record. All permission requests should be directed accordingly and not to the Sigma Repository. All submitting authors or publishers have affirmed that when using material in their work where they do not own copyright, they have obtained permission of the copyright holder prior to submission and the rights holder has been acknowledged as necessary.
Review Type
Faculty Approved: Degree-based Submission
Acquisition
Self-submission
Date of Issue
2026-05-12
Full Text of Presentation
wf_yes
Description
MSN- Nurse Practitioner Students at Charles R. Drew University of Medicine and Science Mervyn M. Dymally College of Nursing (MMDCON) - Class of 2026 Nursing Research : NUR635 Malu-Kanoa Hewitt, Briana Morris, Dolly Ukpong, Lula Teklehaimanot, Preet Kamal Singh, Latasha Scott; under the supervision and mentorships of Dr. Chimwala-Selico