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A GAPS Approach to Screening & Health Guidance for Suicide and Depression

The Guidelines for Adolescent Preventive Services (GAPS) approach is a model that uses a systematic strategy for screening and health guidance by primary care physicians. This approach is designed to identify whether an adolescent engages in or is at risk for suicide and/or depression. More information on the development of GAPS as a framework for the organization and content of clinical preventive services is available.

View the GAPS algorithm for suicide and depression (PDF, 125 KB requires Adobe® Reader®)

View GAPS information below designed to identify those adolescents at risk for adverse consequences related to suicide and depression:

Please note that these links may take you off of the AMA Web site. The AMA is not responsible for content on non-AMA Web sites. A listing here does not indicate endorsement by the AMA.

Gather Information
Gather information and ask questions (PDF, 44KB)

Other screening tools:

Centers for Disease Control and Prevention Youth Risk Behavior Surveillance System (information on trends and prevalence of adolescent suicide and depression)

Adolescent suicide, depression, and mental health reading list (PDF, 64KB)

Assess Further
Assess further and ask follow up questions (PDF, 43KB)

Problem Identification
Problem identification (PDF, 51KB)

Mild depression
Moderate to severe depression
High risk for suicide

Solutions
Solutions (PDF, 41KB)

Supportive counseling
Refer for psychiatric evaluation
Immediate hospitalization and psychiatric evaluation

Note: The GAPS information provided above was adapted from Levenberg PB, Elster AB. Guidelines for Adolescent Preventive Services (GAPS) Clinical Evaluation and Management Handbook. 1996. Chicago: American Medical Association.

Best practices and clinical guidelines resouces:

Suicide Prevention Resource Center Best Practice Registry for Suicide Prevention

National Guidelines Clearinghouse

SAMHSA's National Registry of Evidence-based Programs and Practices

Clinical trials and research resources:

National Insititute of Mental Health- Clinical Trials: Depression

Treatment for Adolescents with Depression Study: A Clinical trial sponsored by the National Institute of Mental Health

Curriculum, video/Web casts, CME, and online workshops:

American Academy of Child and Adolescent Psychiatry Online CME

American Academy of Child and Adolescent Psychiatry Strong Minds videos

National Institute of Mental Health Curriculum Supplement for Middle School: The Science of Mental Illness

Videos of NIMH-sponsored lectures: Treatment for Adolescents with Depression Study (TADS) and Great Teachers- Suicidal Risk in Adolescents: Assessment and Treatment