Impact of COVID-19 on Youth and Adolescent Behavioral Health

The purpose of this survey is to understand your perspective on the impact of COVID-19 on behavioral health and substance use among youth and adolescents.

Please answer the following questions as they relate to changes experienced or observed over the past year (since June 2020) until now. As you go through the questions, keep in mind that behavioral health is also defined to include substance use symptoms.

Responses to this survey are confidential and will be reported in aggregate.

Question Title

* 1. Please identify your specialty

Child and Adolescent Psychologist

Family medicine physician

Nurse Practitioner

Pediatrician

Physician Assistant/PA

Other (please specify)

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* 2. Which best describes your practice setting?

Academic health center

Federally Qualified Health Center (FQHC)

Hospital owned clinical or practice

Independent private practice

Private equity owned practice

Other (please specify)

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* 3. Please identify all ethnic groups for which you care and enter approximately what percent of all patients they constitute in your practice setting. The total percentage must equal 100% for all selected options.

American Indian or Alaska Native

Asian

Black or African American

Hispanic/Latinx/Spanish

White or Caucasian

Multiple race/Biracial

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* 4. Approximately what percent of your patients are on public insurance (i.e. Medicaid)?

0-5%

6-10%

11-25%

26-50%

51-75%

76-95%

96-100%

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* 5. What zip code is your primary practice located?

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* 6. Since June 2020, are you seeing more, the same or less of your patients present with behavioral health symptoms?

Same

Less

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* 7. If you answered more, which problems are you seeing increased? Please select ALL that apply.

Acute Traumatic Stress

Attention Deficit Hyperactivity Disorder (ADD/ADHD)

Anxiety

Behavioral issues not previously present

Depression

Eating disorders

Substance use not previously seen

Suicidality

Other (please specify)

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* 8. Since June 2020, what change in office visits include behavioral health issues? Please select the closest to what you would estimate.

Significant decrease

Small decrease

No change

Small increase

Significant increase

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* 9. If your practice uses behavioral health screening tools, which ones are you using? Please select ALL that apply.

Ages and Stages 2- Social Emotional Screening tool (EC)

GAD-7 (Generalized Anxiety Disorder Screen)

PSC-17 or PSC-35 (Pediatrics Symptoms Checklist)

PHQ-9 or PHQ-2 (Patient Health Questionnaire)

SMFQ or MFQ (Moods and Feelings Questionnaire)

EPDS (Edinburgh Postnatal Depression Scale)

SDQ (Strengths and Difficulties Questionnaire)

ASQ (Ask Suicide screening Questions)

C-SSRS (Columbia Suicide Severity Rating Scale)

CDI (Child Depression Inventory)

Vanderbilt assessment scale (ADD/ADHD)

SCARED (Self-Report for Childhood Anxiety Related Emotional Disorders)

Connors scale (ADD/ADHD)

Other (please specify)

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* 10. What are the biggest needs you are seeing in your patients? (Choose up to 3)

Access to telehealth resources for behavioral health

Access to child and adolescent psychiatry services

Loss of someone important due to COVID-19

Parental stress related to COVID-19 (i.e. work/school balance with virtual learning, job security/unemployment)

Social isolation/loneliness

School stress (such as inability to go back to school)

Worry about contracting COVID-19

Other (please specify)

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* 11. Are you able to meet the increased behavioral health needs of your patients?

Yes

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* 12. Do you feel comfortable meeting your patients behavioral health needs?

Yes

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* 13. In which age ranges are you seeing an increase in behavioral health needs. Please select ALL that apply

0-5 years old

6-10 years old

11-15 years old

16-20 years old

>20 years old

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* 14. Thinking about the next 6 months, to what extent do you anticipate an increase in behavioral health needs during your visits?

No increase

Small increase

Moderate increase

Significant increase

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* 15. What is your age range?

18-24

25-44

45-54

55-64

65+

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* 16. What is your identified race/ethnicity?

American Indian or Alaska Native

Asian

Black or African American

Hispanic/Latinx/Spanish

Native Hawaiian or other Pacific Islander

Middle Eastern/North African

Multiple race/Biracial

White or Caucasian

Prefer not to answer

Unknown

Other/self-described (option not listed)

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* 17. What is your sex?

Male

Female

Prefer not to answer

Other (please specify)