Youth StepCare: A pilot study of an online screening and recommendations service for depression and anxiety among youth patients in general practice.
Abstract Background: General Practitioners (GPs) are ideally placed to identify and manage emerging mental illness in young people, however, many report low levels of confidence in doing so. A web-based universal screening service delivered via a mobile tablet, Youth StepCare, was developed to assist GPs in identifying depression and anxiety symptoms in youth patients providing evidence-based treatment recommendations and fortnightly monitoring of symptom progress. The current study assessed the feasibility and acceptability of delivering the Youth StepCare service in Australian general practices among GPs, practice staff, and youth patients. Methods: A 12-week uncontrolled trial was undertaken between August 2018 and January 2019 in two general practices in NSW, Australia. The service was offered to all youth patients aged 14-17 years who visited their participating GP during the screening period alongside their parent or guardian. Youth patients reported the presence of depressive and anxiety symptoms using the self-report Patient Health Questionnaire-9 and the Generalised Anxiety Disorder Questionnaire-7. New cases were defined as those who were experiencing symptoms and were not currently visiting their GP, nor had previously sought help for mental health issues. Feasibility and acceptability of the service among GPs, practice staff, and youth patients was assessed using a battery of questionnaires. Results: Five GPs and 6 practice staff participated in the trial. A total of 46 youth patients were approached and 28 consented to participate. Of these, 19 completed the screener (67.9%). Nine reported symptoms of anxiety or depression, two of which were new cases (22.2%). GPs and practice staff were satisfied with the service, reporting that there was a need for the service, and that they would use it again. Youth patients also reported the service was easy to understand and didn’t cause distress. Conclusions: Although young people account for a small proportion of patients visiting their GP, the Youth StepCare service appears to be a useful tool for identifying youth with undeclared symptoms which can be easily embedded into general practice. Further research would benefit from exploring reasons for lower GP uptake and a larger trial is required to determine the efficacy of the service on symptom reduction.