Mental health screening in the orthodontic setting: A feasibility study

Introduction: Mental health is a key component of overall well-being. Adolescents often experience gradual changes in their mental health, which can go unnoticed and undiagnosed. The aims of this study were as follows: (1) to assess the feasibility of implementing mental health screening for adolescent patients in the orthodontic setting and (2) to examine the difference between guardian and patient responses. Methods: The Pediatric Symptom Checklist (PSC), a questionnaire used to identify emotional and behavioral issues, was employed as a screening tool in the orthodontic setting. Participants included children aged 12-17 years and their legal guardians. Measures of feasibility included the following: survey acceptance rate, survey completion rate and duration, and patient and guardian responses to questions related to the importance of screening and willingness to participate again. Analysis of overall and subscale checklist scores, as well as concordance between patient and guardian responses, was used to assess the difference in checklist responses. Results: A total of 100 orthodontic patients and their legal guardians completed a modified version of the PSC in an average of 3-4 minutes. Overall, 14% patients had scores ≥15, indicating significant problems with emotion and behavior, compared with just 2% guardians. There was a significant difference between the mean PSC score for participants (8.22) and guardians (5.45) (P <0.01). Concordance of responses between participant and guardian was low to moderate for many factors on the PSC. Conclusions: Screening for mental health in the orthodontic setting is easily implemented and can help identify patients who require additional support and intervention.