Quality Improvement Project: Implementation of the Patient Health Questionnaire-9 Modified for Teens
Document Type
Article
Publication Date
6-20-2026
Abstract
Background: Adolescent depression is a prevalent and significant public health concern, strongly linked to increased suicidality, poor health outcomes, impaired psychosocial functioning, and substantial societal costs. Although measurement‑based care using validated screening instruments is recommended by clinical practice guidelines, routine use of standardized depression screening tools remains limited in mental health settings.
Objective: The purpose of this quality improvement project was to assess the impact of implementing the Patient Health Questionnaire-9 modified for teens (PHQ-9M) in depression screening rates among adolescents aged 11-17 years at an outpatient mental health clinic in Southern Colorado.
Methods: A quantitative, quasi‑experimental pre- and post-intervention design was used to evaluate changes in depression screening rates following an 8‑week implementation period. The intervention included integrating the PHQ-9M into the clinic's electronic health records and providing clinician training. Pre- and post-intervention screening rates of three participating clinicians were compared using a chi‑square test of independence.
Results: Prior to implementation, no adolescent patients received standardized depression screening (0%). Following implementation, the screening rates increased to 15.8% (22 of 139 de-identified patient chart data). The increase was statistically significant (χ²(1) = 17.265, p < .001), indicating a strong association between PHQ‑9M implementation and improved screening practices.
Conclusions: Integrating the PHQ‑9M into routine clinical workflows significantly increased adolescent depression screening rates in a mental health clinic setting. These findings support the feasibility and effectiveness of implementing validated measurement‑based care tools to enhance early identification of depression. Addressing implementation barriers, such as electronic health records usability and clinician engagement, may further improve adoption and sustainability. Routine use of standardized screening tools can improve early detection, timely intervention, and mental health outcomes for adolescents.
College/Unit
College of Health and Public Administration
Academic Department
Nursing
Publication or Event Title
International Journal of Nursing
Volume
13
First Page
1
Last Page
22
ISSN
2373-7670
DOI
10.15640/ijn.v13p1
Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.
Recommended Citation
Gerber, H., Buchko, L., & Van Winkle, J. (2026). Quality Improvement Project: Implementation of the Patient Health Questionnaire-9 Modified for Teens. International Journal of Nursing, 13, 1-22. https://doi.org/10.15640/ijn.v13p1
Included in
Health Services Administration Commons, Nursing Commons, Psychiatry and Psychology Commons
