Robust Parental Preferences in Mental Health Screening in Youth From a Multinational Online Survey
Authors: Kass Mirelle , Alexander Lindsay , Moskowitz Kathleen , James Najé , Salum Giovanni Abrahão , Leventhal Bennett , Merikangas Kathleen , Milham Michael Peter 
Published: February 2023

ABSTRACTImportanceScreening youth for mental disorders may assist in prevention, promote early identification, and reduce related lifetime impairment and distress.ObjectiveThe goal was to survey parents about their comfort and preferences for pediatric mental health screening, as well as factors associated with these preferences.DesignThe online survey was available July 11-14, 2021 on Prolific Academic. Analyses were conducted from November 2021 to November 2022.SettingOnline survey.ParticipantsThe survey was administered to English-speaking parents with at least one 5-21-year old child at home. The sample included 972 parents, aged 21 and older, from the United States (n=265), United Kingdom (n=282), Canada (n=171), and Other Countries (n=254).Exposure(s)None.Main Outcome(s)/Measure(s)Parental preferences regarding the screening content, implementation preferences, and screener reviewing preferences of pediatric mental health screening were assessed in a novel survey. Mixed effects logistic models were employed to evaluate factors that influence parental comfort levels.ResultsParents, aged 21 to 65 (M=39.4; 62.3% female), supported annual mental health screening for their child and preferred reviewing the screening results with professional staff (e.g., physicians). Parents preferred parent-report over child self-reports, though they were generally comfortable with both options. Despite slight variations based on country of residence, screening topic, and child’s age, parents were generally comfortable discussing all 21 topics. The greatest comfort was with sleep problems; the least comfort was with firearms, gender identity, suicidality, and substance use/abuse.Conclusions/RelevanceOur data indicated that parents support annual parent- and child self-report mental health screening in primary care settings, but comfort levels differ according to various factors, such as screening topic. Parents preferred screening to occur in the healthcare office and to discuss screening results with professional staff. In addition to parental need for expert guidance, the growing awareness of child mental health needs highlights the importance of addressing mental health concerns early via regular mental health screenings.KEY POINTSQuestionWhat are parents’ attitudes towards pediatric mental health screening in primary care settings?FindingsThe vast majority of parents surveyed online (N=972)expressed comfort with the screening of children for mental health concerns in the primary care setting. Variations in comfort were noted in relation to age of child and topics included. Parents expressed a preference for parent report over child report, as well as for reviewing screening results with professional medical staff. These findings were robust to the country of residence (e.g., United States, Canada, United Kingdom).MeaningOur findings document parental preferences that should be incorporated to enhance the feasibility of mental health screening in primary care settings.