When you are with a patient, do you wait for them, or their parents, to bring up any additional concerns? Do you screen, formally or not, for behavioral health concerns? Would you be more likely to ask about mental health concerns if you knew only about half of parents would bring them up with you? According to a new national poll conducted by C.S. Mott Children's Hospital, "61% of parents definitely would discuss a situation where their child has been extremely sad for over a month, but only half would discuss temper tantrums that seem worse than other kids the same age, or their child being more worried or anxious than usual". Since only half of parents would discuss mental health concerns with their pediatrician, it's important to inquire about, and even screen for, any concerns with each and every patient.




The DEF Protocol provides a guideline for doctor and nurses to assess the mental health of their patients after an injury or illness, without adding additional work to their visit.  The DEF Protocol addresses distress, emotional support and family needs of the patient and family with short and simple questions, such as:


Actively assess and treat pain.

Fear and anxiety

Minimize traumatic aspects of treatment / procedures.

Ask about fears and worries.

Provide reassurance and realistic hope.

Help child and parents identify support needs & effective coping strategies.

Are parents able to be with child for procedures?

Are parents able to help calm and soothe child?

Ask parents, siblings, other family members how they're doing.

Help family identify strengths and coping resources.

Address other needs (beyond medical)


Do you regularly screen your patients for emotional health concerns? Are there barriers preventing you from addressing mental health concerns with your patients? Join in the discussion on our Facebook page!