Domain 8: Mental Health and Psychosocial Factors



Assess existing and new mental health symptoms and disorders. 

Level of Evidence:

Experienced and trained healthcare professionals should use appropriate screening tools to assess the child/adolescent. These assessments should be considered for children/adolescents with a history of mental health problems or with prolonged post-concussive symptoms. 

Use Tool 8.1: Post-concussion mental health considerations algorithm and refer to a mental health specialist using clinical judgment.

Assessment screening tools to consider (direct website links):


Assess the child/adolescent’s broader environment, including family and caregiver function, mental health, and social connections. 

Level of Evidence:   

  • Ask about socioeconomic status (caregiver education, family income, occupation).
  • Ask about social impacts and life stressors (school setting, friends, teammates).
  • Ask the child/adolescent and parents and/or caregivers to complete the following, as appropriate:


Treat mental health symptoms or refer to a specialist in pediatric mental health. 

Level of Evidence:   

Base the mental health treatment on individual factors, patient preferences, the severity of symptoms, and co-morbidities.

Tools to assist healthcare professionals to make treatment decisions:

Consider referring to a local healthcare professional, specialized pediatric concussion program or to a specialist with experience in pediatric mental health if child/adolescent has prolonged or urgent mental health symptoms. Provide the name of a specialist with experience in pediatric mental health.

For deciding when to refer a child/adolescent to a specialist, use Tool 8.1: Post-Concussion Mental Health Considerations Algorithm