How a Web-Based Questionnaire Can Help Prevent Teen Suicide

Getting teenagers to talk about what’s bothering them isn’t always easy. But with new guidelines from the American Academy of Pediatrics recommending depression screening for adolescents (ages 11-21) during their annual physical, getting teens talking at the doctor’s office is a must.

Drexel’s Guy Diamond, PhD, is ahead of the curve in developing and disseminating tools that can help. With collaborators at the Children’s Hospital of Philadelphia (CHOP) and Medical Decision Logic, Inc., Diamond has helped develop a web-based screening tool called Behavioral Health Works that is helping facilitate screening, triage and prevention services for at-risk teens — not just for depression, but for many factors that could contribute to the risk of suicide in teens.

The program is currently a finalist for the Scattergood Foundation’s annual Innovation Award for making an impact on solving behavioral health problems. Diamond and his collaborators and Drexel’s College of Nursing and Health Professions are seeking help from the community to cast votes in support of the program online here. Voting closes on March 17, 2014.

Behavioral Health Works is used in 40 Pennsylvania sites screening 1,000 patients per month in primary care practice offices, emergency departments, college health centers, schools and mental health facilities. The New York Department of Health has licensed the program for use in primary care practice offices across 26 counties.

An overview of the workflow for the Behavioral Health Works system. All patients are screened. A nurse or other staff member gives an orientation. A logon is created. The patient completes the BHS in a private setting. Staff/Nurse prints and adds the report to patient chart or EMR. Provider reviews report with patient and makes referrals if needed. Report and provider's review may be billable.

At the core of the program is the web-based Behavioral Health Screen (BHS)—a questionnaire measuring multiple factors that affect a teen’s risk: depression, suicidality, trauma, substance use, sexuality, gun access, bullying, violence exposure and other risk behaviors.

It’s important to ask about these multiple factors because, Diamond said, with teens’ suicide risk “things are more complicated than just depression. Adolescents can be experiencing problems that put them at risk, even if they are not depressed.”

Diamond also noted that the Behavioral Health Works program asks about broader timeframes than most depression screening tools which ask about signs of depression within the last two weeks. “Depression is episodic,” Diamond said. “When kids go to the doctor for their back-to-school physical in August, think about how they’ve been spending their time: They probably haven’t been depressed in the last two weeks.”

Patients take about seven minutes to complete the self-report questionnaire on a computer during a medical visit prior to seeing the health care provider. The questionnaire is automatically scored and a report is generated for review during the clinical encounter.

“It helps focus the conversation for the health provider,” Diamond said. The report can also be saved in a patient’s electronic medical record and be shared with a mental health provider as needed.

In addition to the screening tool, the Behavioral Health Works program integrates prevention, triage and tracking services.

Guy Diamond, PhD

Diamond, a leading expert in evidence-based family therapy techniques in treating teen depression and preventing teen suicide, joined Drexel from CHOP last year, initially as a visiting faculty member, and now as a permanent, full-time member of the faculty in the College of Nursing and Health Professions. He directs the doctoral program in Couple and Family Therapy as well as his own Center for Family Intervention Science.

Only a few days remain to cast votes for the Scattergood Foundation’s 2014 Innovation Award. The finalists are outstanding examples of programs that make an impact on solving behavioral health problems in the community. Voting closes on March 17, 2014. To vote for Behavioral Health Works, visit the program’s description page here.

Members of the news media interested in interviewing Diamond about teen depression screening may contact Rachel Ewing in the Drexel University Office of University Communications at or 215.895.2614.

For more information about suicide prevention, visit the Suicide Prevention Resource Center.