Increasing Access to Depression Treatment for Rural Adolescents


Supported by the Michigan Health Endowment Fund, Altarum is working to increase access to depression treatment for adolescents in rural Michigan using behavioral healthcare integration and telehealth in primary care settings.


In partnership with the Michigan Center for Rural Health, the Upper Midwest Telehealth Resource Center, and CISCO, the Altarum team is providing the following services:

  • Developing and delivering continuing education (CE) to primary care providers on adolescent depression screening, treatment, and follow-up;
  • Providing clinicians with stand-alone telehealth units and a HIPAA compliant telehealth software package;
  • Providing CE training for behavioral health and primary care clinicians on telebehavioral telehealth;
  • Providing on-demand technical assistance to help primary care clinicians integrate telehealth and adolescent depression screening and treatment into their existing workflow (including maintenance of certification (MOC) credits);
  • Creating a ‘pediatric telehealth network’ enabling rural providers to consult with behavioral health providers and adolescents in primary care offices; and
  • Evaluating the impact of the Responding to Adolescent Depression through Integration and Telemedicine (RAD-IT) program on the behavioral health outcomes of over 2,000 rural Michigan adolescents.


This project addresses the significant challenges rural adolescents face with accessing person-centered and integrated mental health services in a timely and affordable manner. The RAD-IT program has had a positive impact on adolescents and clinicians, including:

  • Increased screening rates for adolescent depression (28% at baseline, 81% post-training)
  • Improved scores on the PHQ-A—a measure that assesses the severity of clinically significant symptoms of depressive disorders and episodes—in 64% of adolescents who received follow up appointments
  • Increases in clinician confidence in screening for and treating depression (61% at baseline, 96% post-training)
  • Improved clinician knowledge of and comfort in prescribing antidepressants for adolescents in need (76% at baseline, 88% post-training)


Jessica McDuff
Program Director, Behavioral Health