DOI

10.21007/con.dnp.2025.0129

Faculty Advisor

Ja’Quay Brister, DNP, PMHNP-BC & Margaret Harvey, PhD, APRN, ACNP, CHFN, FHRS

Document Type

Poster

Publication Date

Fall 11-1-2025

Disciplines

Health and Medical Administration | Investigative Techniques | Medicine and Health Sciences | Nursing | Nursing Administration | Quality Improvement

Abstract

Purpose/Background

Adolescents' mental health has worsened and become a public health issue, with depression being a primary concern. There is an urgent need for early screening, school-based referral pathways, and interventions to address common problems in high schools. Patient Health Questionnaire-9 (PHQ-9) is a validated, evidence-based tool for detecting depression; however, its systematic use in school-based counseling settings through organized training has not been studied for implementation in high schools. This review assesses the current literature on the impact and effectiveness of PHQ-9 training for school counselors on mental health referrals among high school students, with a focus on early identification and referral rates.

Methods

A comprehensive search of peer-reviewed literature was conducted using PubMed, MEDLINE, CINAHL, PsycINFO, Scopus, ScienceDirect, the Cochrane Library, and Google Scholar for studies published between 2016 and 2024. Inclusion criteria targeted peer-reviewed studies involving high school students (ages 14–18) and school counselor training on the PHQ-9, with measurable outcomes related to mental health referral rates and mental health literacy. Non-peer-reviewed studies and those not in English were excluded. Six studies meeting these criteria were evaluated and synthesized.

Results

The findings of the review suggest that PHQ-9 training for school counselors enhances early identification and referral of high school students experiencing symptoms of depression. The results demonstrate that counselors who receive training in using the PHQ-9 are more confident in their screening abilities and are more likely to make mental health referrals.

Implications for Nursing Practice

The PHQ-9 consistently demonstrated reliability, sensitivity, and specificity in screening for depression. Future research should focus on long-term outcomes, expanded PHQ-9 training programs, and the establishment of partnerships between schools and mental health providers to ensure proper follow-up care. Schools should implement mandatory training workshops to enhance counselor readiness and address stigma through awareness campaigns that target both students and parents.

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