Impact of implementing mental health screening by mail with a primary care management model

Lindsay R. Hunter, Brian A. Lynch

Research output: Contribution to journalArticlepeer-review

3 Scopus citations


Background: Early recognition and treatment of social and emotional disorders in children is significant for school preparation. These disorders are frequently underdetected without the use of standardized screening instruments. The purpose of our study is to describe the implementation of the Ages and Stages Questionnaire: Social-Emotional (ASQ:SE) in primary care practice by mail when children are 30 months old. Methods: In this 4-month study, parents of all 30-month-old children who receive primary care at our study site were mailed the ASQ:SE. In children who did not pass screening or received a call from a registered nurse for parental concerns documented on the questionnaire, short-term clinical outcomes were obtained from the electronic medical record. During the last month of the study, the demographics variables of race and insurance type were analyzed for an association with questionnaire completion by mail. Results: Of the 870 families mailed 30-month ASQ:SE screens, 507 (58.3%) were returned by mail. Out of the children with returned screens, 38 (7.5%) of parents were contacted for either elevated scores or concerning comments and 6 (1.2%) were referred to Early Intervention. Parents of children with government insurance returned the ASQ:SE questionnaire 34.2% (13/38) of the time compared with 65.5% (76/116) of those with private insurance (P <.001). Conclusion: Our results indicate that mental health screening can be effectively managed in primary care practice by a registered nurse using a follow-up protocol. Mailing the ASQ:SE is likely not an effective way to comprehensively screen most primary care populations.

Original languageEnglish (US)
Pages (from-to)9-13
Number of pages5
JournalJournal of Primary Care and Community Health
Issue number1
StatePublished - Jan 2014


  • Behavior
  • Child
  • Mass screening
  • Mental health
  • Parents
  • Questionnaires

ASJC Scopus subject areas

  • Community and Home Care
  • Public Health, Environmental and Occupational Health


Dive into the research topics of 'Impact of implementing mental health screening by mail with a primary care management model'. Together they form a unique fingerprint.

Cite this