Abstract
Background The number of adolescents presenting with psychosocial issues at urban hospital pediatric emergency departments have increased significantly since 2000. Early psychological intervention has been proven to prevent future disabilities. Consequences from missing or delayed diagnosis of psychosocial issues in adolescence include increased suicide incidences and potential harm from extensive and invasive investigations. However, there is limited time and resources to evaluate youth for psychosocial stressors in healthcare facilities (Emergency department, clinics). Commonly, medical concerns are addressed first. Furthermore, youths are reluctant to disclose threats to their mental and social well-being when reviewed.
Objectives The effectiveness of technology in psychosocial screening of adolescents in urban health care settings was examined. Specifically, the rate and scope of detection of psychosocial stressors. This would allow for better understanding on how mental health screening resources for adolescence should be allocated. Advancements in psychosocial technological screening can potentially prevent unnecessary consumption of healthcare resources.
Methods A scoping review was used to study scientific literature regarding screening methods for mental health disorders in adolescence. Arksey and O’Malley framework was used to review articles from electronic databases such as BMJ, Cochrane, EBM, Pubmed, Uptodate. The review included cohort and experimental studies of adolescents (12–18 years old) from urban areas who were screened for mental health disorders using different screening tools. A secondary reviewer was asked to do further analysist of the articles during the second round of screening of the articles. Analytical research methods were then used to compare the detection rates and time taken to detect mental health problems in adolescence, using the various screening tools, both online and face to face.
Results 113 search articles were identified. 79 articles were yielded to be utilised in the review. Journal articles were included in the review if they were in English, published after 2000, conducted in metropolitan areas. Youths included in the studies were those who sought help at healthcare facilities (bothemergency department or clinic) in densely populated cities with easy access to both healthcare facilities and technology. Screening tools studied included standalone screening specific softwares, internet based softwares, telephone applications. Most screening tools utilised questionnaires and 3 utilised games. Journal articles studied included 37 randomized controlled trials, 14 Meta-Analysis, 7 Systematic Review, 2 Cohort Studies.
59 articles reflected that online psychosocial tools reached a wider spectrum of youths. 43 indicated that number of youths willing to undergo screening increased when online psychosocial tests were utilised. Screening rates for psychosocial problems of the target population of adolescence increased 6%, compared with traditional face-to-face interview methods. Furthermore, youths were more willing to share openly on an online platform according to 5 research articles. As such, identification of mental disorders in youths was faster and more accurate when an online platform was utilised. Because of that, disclosure rate of the psychosocial stressors increased by 17% when online screening tools were utilised.
Conclusions It can be concluded that online screening tools are more effective, with regards to speed and scope of detection of mental health disorders amongst adolescence living in urban areas.
