Adolescent depression is a major public health problem affecting up to 10% of our youth [1]. Left untreated, the condition causes untold suffering, adversely influences the course of development at a critical stage of life, and is associated with a variety of negative outcomes including academic failure, juvenile delinquency, substance use disorders, and suicide [2, 3]. On the basis of these considerations, along with evidence of the availability of accurate and feasible screening instruments and the effectiveness of treatment, the U.S. Preventive Services Task Force upgraded its recommendation for all adolescents aged 12–18 years [4]. Despite this recommendation and advocacy from the American Academy of Pediatrics [5, 6], the practice of screening has been far from universal in pediatric primary care settings [7]. According to the principle of operant conditioning, people are unlikely to continue a behavior which is consistently followed by a painful stimulus. Arguably, feelings of helplessness and frustration experienced by a provider lacking the knowledge, skills, and resources for addressing a positive depression screen would count as a painful stimulus. Additional barriers to screening may include a lack of knowledge about the effectiveness of screening in identifying cases and the effectiveness of treatment and a need for help in selection and implementation of a screening procedure ...
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", language="en", issn="1054-139X", doi="10.1016/j.jadohealth.2019.04.018", url="http://dx.doi.org/10.1016/j.jadohealth.2019.04.018" }