Beyond Physical Health: Integrating Mental Health Screening in Pediatric Care Settings

Background: Mental health disorders affect a substantial proportion of children and adolescents, yet many cases remain undetected in primary care settings. Professional organizations strongly endorse routine mental health screening in pediatric practice, but implementation remains inconsistent. Objective: This narrative review synthesizes current evidence on integrating mental health screening in pediatric care settings, examining the rationale, current practices, validated instruments, implementation strategies, barriers and facilitators, outcomes, and future directions. Methods: We reviewed systematic reviews, implementation studies, quality improvement projects, and clinical guidelines addressing mental health screening in pediatric primary care. Results: While numerous validated screening instruments exist and professional guidelines support routine screening, implementation faces multifaceted barriers including time constraints, inadequate training, workflow challenges, and limited mental health service access. Successful integration requires systematic approaches including collaborative care models, co-located behavioral health services, quality improvement methodologies, and addressing provider-level and system-level barriers. Evidence demonstrates that systematic screening increases identification rates and facilitates earlier intervention, though sustained implementation requires ongoing support, adequate resources, and workflow alignment. Conclusion: Mental health screening integration in pediatric primary care is feasible and beneficial but requires comprehensive implementation strategies, enhanced training, improved reimbursement models, and system-level support to achieve widespread adoption and sustained practice.