Case Study

Assessing Teen’s Mental Health

Min is a bright and active 17-year-old who is in your office for a Texas Health Steps preventive medical checkup. Min’s mother extols her daughter’s accomplishments and plans, but Min seems subdued and looks at the floor while her mother speaks. As part of the checkup, you ask Min’s mother to step into the waiting room while you speak privately with Min.

You take an open-ended, nonjudgmental approach to the discussion. “Min, it’s obvious how proud your mother is, but I’d like to hear more about how you think things are going.”

The girl tells you she’s not the successful, well-adjusted student her mother described. She feels anxious and tired, has trouble concentrating, and is unsure what to do after graduation. She thinks there may be something seriously wrong but doesn’t want to worry her parents. Min’s physical exam reveals no medical issues that would explain her symptoms, and her medical record indicates that she has not been screened for mental health problems as an adolescent.

portrait of teen girl
Patient
Min
Sex
Female
Age
17 years

What first step should you take as part of Min’s Texas Health Steps checkup to address the teen’s mental health status?

Conduct a mental health screening using a Texas Health Steps-approved screening tool in addition to the routine behavioral, social, and emotional development screening required at every Texas Health Steps preventive medical checkup.

Counsel Min to discuss her concerns with her mother and offer to facilitate a discussion in the office. Provide Min and her mother with a list of community mental health resources that may able to provide additional services.

Respect Min’s desire not to discuss her concerns with her parents. Refer Min to community mental health center and urge her to seek services.

Related Texas Health Steps course

photo of physician and teen patient

Promoting Adolescent Health

Adopt best practices for adolescent screening, including recommended schedules, effective communication, and enhanced clinical procedures. Includes video examples of effective screening techniques.

Credit hours: 1.75 Ethics CME

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About Texas Health Steps

Texas Health Steps’ award-winning online program offers FREE CE courses for primary care providers and other health professionals. These courses offer updated clinical, regulatory, and best practice guidelines for a range of preventive health, oral health, mental health, and case management topics.