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One of the main goals of TX-YDSRN is to expand the use of measurement-based care (MBC) in the state of Texas. To assess the current use of standardized measurement across the sites participating in TX-YDSRN, a dedicated committee developed a data collection tool designed to describe whether and how the patients were assessed for depression, anxiety, treatment side effects, and adherence. A subsequent chart review of clinical visits indicated that 71% of sites used standardized depression measures and 64% used anxiety measures. When it came to measures assessing medication adherence and side effects, those were limited to less than 6% for both (despite medication changing in nearly half of the participants), with the majority of the sites using clinical interviews to gauge adherence and side effects. Considering that the use of MBC has been linked to better outcomes in mental health treatment, it is crucial to continue to increase the use of standardized tools.

Slater, H., AlZubi, Y., Rezaeizadeh, A., Hughes, J. L., Gorman, A., Mayes, T. L., Elmore, J. S., Storch, E. A., Wakefield, S. M., & Trivedi, M. H. (2025). Characterizing Measurement-Based Care in the Texas Youth Depression and Suicide Research Network (TX-YDSRN). Child Psychiatry and Human Development, 56(5), 1214–1224. https://doi.org/10.1007/s10578-023-01653-3

• Measurement-Based Care
• Depression
• Anxiety
• Suicidality

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There are multiple evidence-based therapy treatment options for youth with depression and/or suicidality, yet youth seeking treatment do not always receive these recommended treatments. Understanding the types of treatments received and patient understanding of their therapy experience is the first step to help track care in order to improve treatment received. To that end, TX-YDSRN assessed the validity of a new measure, the Depression Treatment Experiences Questionnaire (DTEQ), to better understand the youth experience with therapy. The measure showed promise as a useful tool for understanding therapy experiences, with two main domains identified by the measure. Lifestyle changes, such as changes to exercise and sleep, were found as a common addition to therapy. While almost half of participants reported receiving evidence-based therapy, the other half could not identify their therapy type, indicating a large gap in patient-provider communication.

Drummond, K. N., Guzick, A. G., Spencer, S. D., Pinciotti, C. M., Bivins, E. J., Minhajuddin, A., Slater, H., Gorman, A., Goodman, L. C., Walker, R. A., Wakefield, S. M., Wang, T., Chanoi, C., LaGrone, J. M., Soares, J. C., Smith, M., Lambie, F., Hughes, J. L., Snyder, S. A., Storch, E. A. (2025). Characterizing therapy experiences in youth with depression and suicide via the Depression Treatment Experiences Questionnaire. Clinical Psychology and Psychotherapy, 32(3). https://doi.org/10.1002/cpp.70088

• Measurement-Based Care
• Rating scales
• Depression

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Hokelekli, F.O., Ayvaci, E.R., Minhajuddin, A., Walker, R.A., Goodman, L.C., Soares, J.C., Storch, E.A., Wakefield, S.M., & Trivedi, M.H. (in press). Examining Antidepressant Side Effect Burden in Youth: The FIBSER-C Scale in the Texas Youth Depression and Suicide Research Network Study. Journal of Child and Adolescent Psychopharmacology, 35(8), 463-470. https://doi.org/10.1089/cap.2025.0018

• Antidepressant
• Measurement-Based Care
• Rating scales
• Treatment
• Depression

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Measurement-based care (MBC), the use of formal symptom measurements to guide care, has long been used in medicine (i.e., blood sugar for diabetes, or cholesterol for heart disease). However, MBC has not been widely adopted in psychiatry. This review summarizes the available evidence and shows that utilizing MBC to guide clinical decision-making results in better treatment outcomes in patients with treatment-resistant depression. Self-report scales are easily implemented, allowing healthcare providers without extensive psychiatric training, such as primary care physicians, to use valid, reliable, and easy-to-access measurement tools. The use of MBC to implement depression screening, particularly within primary care, likely leads to earlier detection, better treatment adherence, minimization of side effects, and quicker remission.

Mayes, T. L., Deane, A. E., Aramburu, H., Yagnik, K., & Trivedi, M. H. (2023). Improving identification and treatment outcomes of treatment-resistant depression through measurement-based care. Psychiatric Clinics of North America, 46(2), 227–245. https://doi.org/10.1016/j.psc.2023.02.002

• Measurement-Based Care
• Depression
• Treatment-Resistant Depression

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Psychometrically sound measures, ease of administration and scoring, integration with electronic health records, and data-driven suggestions for clinical decision-making are some of the factors that lead to the successful implementation of measurement-based care (MBC) in depression treatment. This study evaluated VitalSign6, a software tool designed to achieve these goals. Almost two thousand youths were screened using VitalSign6 over the course of a year, with almost half of the youth having at least one follow-up assessment. About one quarter achieved remission 4 months after initial screening. Teenagers had higher depression scores, higher suicidality, and more follow-up assessments than younger patients (<12 years of age), while younger patients had higher rates of remission. The process of collecting data and navigating treatment showed that VitalSign6 allows for quick and easy screening of patients, displays clear visual data for providers, and produces tailored treatment recommendations for diverse intervention options. Implementing VitalSign6 eases the MBC rollout process, potentially leading to better outcomes in youth getting treatment for depression.

Mitchell, T. B., Wakefield, S. M., Rezaeizadeh, A., Minhajuddin, A., Pipes, R., Mayes, T. L., Elmore, J. S., & Trivedi, M. H. (2025). Integration of Measurement-Based Care for Youth Depression and Suicidality Using Vitalsign6. Child Psychiatry & Human Development, 56(5), 1206–1213. https://doi.org/10.1007/s10578-024-01680-8

• Measurement-Based Care
• Depression
• Suicidality

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With alarming rates of suicide among youth, the use of valid and reliable suicidality screening tools is vital. Many youths who end up screening positive for suicidal ideation display no apparent mental health challenges, thus screening plays an important role in helping to manage this mental health crisis. This review proposes that primary care is an optimal setting to detect suicidality early and provide appropriate monitoring and care. While the preferred tools used to assess suicidality can vary drastically among providers, with some preferring self-report questionnaires and others relying on clinician-administered forms, they all involve similar questions concerning suicidal thoughts, behaviors, and plans. The authors also provide an overview of available measures of youth suicidality, discussing their psychometric characteristics as well as clinical feasibility.

Busby, D. R., Hughes, J. L., Walters, M., Ihediwa, A., Adeniran, M., Goodman, L., & Mayes, T. L. (2025). Measurement Choices for Youth Suicidality. Child Psychiatry & Human Development, 56(5), 1250–1266. https://doi.org/10.1007/s10578-023-01627-5

• Measurement-Based Care
• Suicidality

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Despite the growing understanding of youth depression, there remains a need for a more precise diagnosis and more effective symptom management. In this article, the authors argue for the use of a variety of research-backed measurements and rating scales to assess depression. The use of these scales produces a more reliable diagnosis and allows healthcare providers to objectively track treatment progress. In addition to measuring depressive symptoms, rating scales can be used to assess related mental health features (e.g. anxiety) and other important outcomes (e.g. quality of life). For some families, completing a depression measure is the first time they hear language that describes their symptoms. This aids in the recognition of at-risk individuals and helps overcome stigma by normalizing discussion of mental health, ultimately leading to more equitable mental health care.

Garza, C., Chapa, D., Hernandez, C., Aramburu, H., Mayes, T. L., & Emslie, G. J. (2025). Measurement-Based Care for Depression in Youth: Practical Considerations for Selecting Measures to Assess Depression, Associated Features and Functioning. Child Psychiatry and Human Development, 56(5), 1235–1249. https://doi.org/10.1007/s10578-023-01652-4

• Measurement-Based Care
• Depression

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While risk factors for poor mental health often receive much attention, factors that protect or promote mental health deserve increased attention. Resilience, or the ability to adapt to life's challenges, has been identified as one protective factor, but there is a need for reliable and valid measures of resilience for research. In this study, we sought to test whether the CD-RISC-10, a brief measure of resilience, is appropriate for use within youth with depression and/or suicidal ideation. Results demonstrated that the CD-RISC-10 is valid and reliable, including over one-month follow up, for this youth population. This work will support future research efforts on understanding resilience and its impact on mental health by supporting the use this brief measure of resilience in at-risk youth.

Jeevarajan, J. R., Theodorou, A., Nandy, K., Guerra, M., Madia, N. D., Claassen, C., Goodman, L. C., Farmer, D., Wakefield, S. M., Minhajuddin, A., Slater, H., Mayes, T., Soutullo, C. A., Rosenberg, A., Ladd, S., Ahumada, N., Jackson, S., Rush, A. J., & Trivedi, M. H. (2025). Psychometric properties of the 10-item Connor-Davidson Resilience Scale (CD-RISC-10) in adolescent and young adult psychiatric outpatients in the Texas Youth Depression and Suicide Research Network (TX-YDSRN). Journal of Affective Disorders, 375, 155-164. https://doi.org/10.1016/j.jad.2025.01.091

• Rating scales
• Measurement-Based Care
• Depression
• Suicidality

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There is a large unmet need for mental healthcare in the United States, where depression is one of the most common psychiatric illnesses. Measurement-based care (MBC) is a strategy that can be implemented in primary care settings to improve patient outcomes over care as usual, and MBC can be applied toward the detection and tracking of depression symptoms. The two components of MBC are 1) the repeated, systematic measurement of symptoms for screening and monitoring and 2) using those measurements to guide treatment. This paper provides an overview of MBC and details the benefits and barriers to implementation in the context of depression treatment. Making MBC standard practice can lead to earlier detection and intervention, increase access to care, and help decrease high rates of untreated depression.

Deane, A. E., Elmore, J. S., Mayes, T. L., Robinson, S., AlZubi, Y., Wakefield, S. M., & Trivedi, M. H. (2025). Shifting From Best Practice to Standard Practice: Implementing Measurement-Based Care in Health Systems. Child Psychiatry & Human Development, 56(5), 1225–1234. https://doi.org/10.1007/s10578-024-01715-0

• Measurement-Based Care

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