Screening, Monitoring, and Referral to Treatment for Young Adolescents at an Urban School-Based Health Center

Robert E. Burke, Neal D. Hoffman, Laura Guy, Jodi Bailey, Ellen Johnson Silver

Research output: Contribution to journalArticlepeer-review

2 Scopus citations


BACKGROUND: This study describes the experience of implementing a screening, monitoring, and referral to treatment (SMARTT) initiative at an urban middle school school-based health center. METHODS: Retrospective data were collected for adolescents screened with the Pediatric Symptom Checklist-17-Y. At-risk adolescents having unmet health needs were offered a mental health referral, and those that declined a mental health referral were offered a primary care monitoring (PCM) visit with the medical provider. Chi-square analyses were used to evaluate differences in screening and outcomes by age, sex, and race/ethnicity. RESULTS: One out of four adolescents had a positive PSC-17-Y or negative screen with other identified concerns. Approximately half of these at-risk adolescents accepted a mental health referral, and 86% of those who declined agreed to the PCM visit. More than two-thirds of the PCM group did not need continued monitoring and support at follow-up, and 85.4% of youth who had a mental health assessment accepted mental health services. CONCLUSIONS: The SMARTT initiative successfully demonstrated that co-located and integrated mental health services can enhance access and connection to mental health services for at-risk youth. In addition, PCM visits were found to be an effective option for youth who declined mental health referrals.

Original languageEnglish (US)
Pages (from-to)981-991
Number of pages11
JournalJournal of School Health
Issue number12
StatePublished - Dec 2021


  • adolescent health
  • mental health
  • pediatric symptom checklist-17-youth self-report (PSC-17-Y)
  • primary care
  • psychosocial screening
  • school-based health centers

ASJC Scopus subject areas

  • Education
  • Philosophy
  • Public Health, Environmental and Occupational Health


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