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Strategies, Screening and Systems of Care

Explore the importance of mental health screening and implementation strategies in various settings to address issues like substance use, depression, and suicide among youth. Learn about barriers, policy considerations, and tools for effective screening and assessment. Discover a range of resources and examples to guide program development and improve outcomes.

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Strategies, Screening and Systems of Care

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  1. Strategies, Screening and Systems of Care Matthew C. Aalsma, Ph.D. Section of Adolescent Medicine Indiana University School of Medicine LEAH/SAHC February 15, 2007

  2. Mental Health ScreeningIntroduction • Need for screening • Case example • Screening for . . . • Domestic/dating violence • Substance use • Depression • Suicide • Health behavior

  3. Mental Health ScreeningIntroduction • Settings include . . . • School • Community mental health • Hospitals • Juvenile justice • Workplace • Health fair

  4. Mental Health ScreeningBarriers and Opportunities • Opponents • Example of Garrett Lee Smith Memorial Act 2004 • Privacy • Issues of consent and assent • President’s New Freedom Commission on Mental Health 2003

  5. Mental Health ScreeningImplementation Three broad considerations for program development: • Context for screening • Context for assessment • Policy considerations

  6. Mental Health ScreeningContext for Screening • Consider objectives • Fulfilling regulatory requirements • Example of juvenile justice • Improving staff decision making • Example of health clinic • Manage resources • Need for data!

  7. Mental Health ScreeningContext for Screening • Practical and financial feasibility • Informant availability • Youth and/or parent • Expertise • Efficiency of administration • Financial cost for materials • Paper/pencil versus computer • Space requirements

  8. Mental Health ScreeningContext for Assessment • Assessment for follow-up screening • Professional consultation • Specific versus general follow-up assessment

  9. Mental Health ScreeningPolicy Considerations • Policies about decisions on screening and assessment results • Responses • Research • Resources • Risk

  10. Mental Health ScreeningPolicy Considerations • Policies about screening and assessment personnel • Policies controlling the use of screening and assessment data

  11. Mental Health ScreeningImplementation Summary • Planning, planning, planning • Coalitions – Bringing parties together • Funding!!!! • National resources

  12. Mental Health ScreeningExample: Pennsylvania • Youth in the juvenile justice system have high rates of mental illness • Estimates for community – about 20% • Estimates for juvenile offenders – over 65% • Fifteen out of 23 juvenile detention centers in Pennsylvania • 18,607 admissions received Massachusetts Youth Screening Instrument Version 2 (MAYSI-2)

  13. Mental Health ScreeningExample: Indiana • Indiana State Bar Association – Civil Rights for Children Report Summer 2005 • Marion County instituted mental health screening Spring 2006 • Statewide pilot project funded through Indiana Criminal Justice Institute Summer 2006 • Submitted 2nd pilot grant to expand program

  14. Mental Health ScreeningTools • Columbia Health Screen (CHS) • Suicide screener, 14 items, about 10 minutes • Diagnostic Predictive Scales (DPS) • General mental health screener, 52 items, about 10 minutes • Massachusetts Youth Screening Instrument Version 2 (MAYSI-2) • General mental health screener, 52 items, about 10 minutes

  15. Mental Health ScreeningResources • Uncovering an epidemic . . . NEJM • http://content.nejm.org/cgi/content/short/355/26/2717 • National screening program from Columbia University • http://www.teenscreen.org/

  16. Mental Health ScreeningResources • Juvenile Law Center – description of Pennsylvania program • http://www.jlc.org/ • Mental Health Screening and Assessment in Juvenile Justice (2005) Edited by Grisson, T., Vincent, G. & Seagrave, D. • http://www.maysiware.com/MAYSI2.htm

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