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The Engagement Paradigm. Establish CommunityShare ContextExchange ContentDiscuss and DeliberateConsensus ? or New ContextExpand Community. MCH Outcomes and Mental Health Outcomes?. A Common Language (?). Developmental HealthBehavioral HealthMental HealthSubstance UseConduct Disorder. Tradit
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1. Inside or Outside our Circle:Do Mental Health Concerns Affect our Outcomes?
CityMatCH Expedition 2004 Conference
September 13, 2004
2. The Engagement Paradigm Establish Community
Share Context
Exchange Content
Discuss and Deliberate
Consensus – or New Context
Expand Community
3. MCH Outcomes and Mental Health Outcomes?
4. A Common Language (?) Developmental Health
Behavioral Health
Mental Health
Substance Use
Conduct Disorder
5. Traditional Maternal and Child Health Populations Women
Pregnant Women
Infants
Children
Adolescents
Adults
6. Tools and Strategies: Identification and Treatment Screening
Case Finding
Diagnosis
ICD-9
DSM IVR
Treatment
Support
Therapy
Medication
7. Youth Risk Behavior Surveillance Survey: 1999Sadness and Suicide Ideation and Attempts Felt sad or hopeless almost every day for >2 weeks preceding survey and stopped usual activities 28.3%
Seriously considered attempting suicide in 12 months preceding survey 19.3%
Attempted suicide > 1 time 8.3%
Suicide attempt requiring treatment (injury, poisoning, overdose) 2.6%
8. Youth Risk Behavior Surveillance Survey: 1999Substance Use Used alcohol (ever) 81.0%
>1 drink alcohol on >1 day of 30 days preceding survey 50.0%
>5 drinks of alcohol on >1 day 31.5%
Used marijuana > 1 time 26.7%
Used methamphetamine (ever) 9.1%
9. Child and Adolescent Mental HealthPrevalence, Persistence, and Diagnosis:1
Anxiety Disorders 13.0%
Mood Disorders 6.2%
Disruptive Disorders 10.3%
Substance Use Disorders 2.0%
* Six month (current) Prevalence, age 9-17
10. Child and Adolescent Mental HealthPrevalence, Persistence, and Diagnosis: 2
Any Disorder 21%
Significant Functional Impairment 11%
Extreme Functional Impairment 5%
11. Child and Adolescent Mental Health“Derailment”
Expelled from School
Drop Out of School
Become Pregnant
Be Convicted of a Crime
Begin Using Alcohol or Other Drugs
12. Child and Adolescent Mental Health“Derailment”
Few or no Mental Health Problems 0.5%
Mild Problems 4.3%
Severe Emotional Disturbance 22.3%
13. Child and Adolescent Mental HealthPrevalence, Persistence, Diagnosis and Treatment
Received any MH Services 40%
Received MH Services from School Counselor 75%
Received MH Services from MH Specialist 12%
Received MH Services from Primary Care 6%
14. Child and Adolescent Mental HealthPrevalence, Persistence, Diagnosis and Treatment
MH Diagnosis and saw MH
Specialist 20%
Parental Recognition and saw MH Specialist 40%
15. Evidence Based PracticeBest Practice
16. Promising Practices School Based Clinics
Expanded School Mental Health
Primary Care/Mental Health Co-location/Integration
Collaborative Practice Arrangements
Youth Development Programs/Initiatives
17. Promising PracticeExpanded School Mental Health
Focused Evaluation
Referrals
Tracking of Referrals
Preventive Services
Full Range of Treatment Services
18. Promising PracticeYouth Development Programs/Initiatives: 1 Goals: promote positive development even when seeking to prevent problem behaviors
Competence
Confidence
Connections
Character
Caring and Compassion
19. Promising PracticeYouth Development Programs/Initiatives:2 Atmosphere: youth as resource to be developed rather than problem to be managed
Activities: formal and informal opportunities for youth to nurture interests and talents, practice new skills, and gain a sense of personal or group recognition
20. Promising Practices EPSDT (with developmental/behavioral tools/checklists)
Bright Futures Mental Health
Brief Motivational Therapy
Brief Interventional Therapy
Cognitive Behavioral Therapy
Medication
21. Resources/References Mental Health: A Report of the Surgeon General
http://www.mentalhealth.org/cmhs/surgeongeneral/surgeongeneralrpt.asp
Youth Risk Behavior Surveillance Survey
www.cdc.gov/HealthyYouth/YRBS
Bright Futures Mental Health
www.brightfutures.org
Center for School Mental Health Assistance
www.csmha.umaryland.edu
The Prevention Researcher
www.TPRonline.org
Evidence Based Practic
http://www.mentalhealth.samhsa.gov/cmhs/communitysupport/toolkits/default.asp.