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Core Tools Framework • Screening Tools • Child and Youth Mental Health (CYMH) Screening Questions • CRAFFT • Primary Assessment Tool • Clinical Global Impression • Scale (CGI) • Secondary Assessment Tools • Depression: KADS6, TASR-A • Anxiety: SCARED • ADHD: SNAP-IV 18 Treatment and Management Tools • Referral • Ministry of Children and Family Development – Child and Youth Mental Health Services • Psychiatrists • Pediatricians • RACE • Strongest Families BC • Kelty Resource Centre • Mood Enhancing Prescription/Worry Reducing Prescription • Teen Functional Assessment (TeFA)/Child Functional Assessment (CFA) • CBIS • Medication Algorithms • Side effects Scales (Kutcher Side Effect Scale for ADHD Medication (KSES-A), Short Chehil-Kutcher Side (sCKS) Effects Scale
Mental Health Screening Q’s • Historical Factors • Parental history of mental disorder • Family history of suicide • Childhood diagnosis of other disorders: www.freedigitalphotos.net by renjith krishnan
Mental Health Screening Q’s • Marked change in usual: • Emotions • Behavior • Cognition, or • Functioning • Based on youth or parent report One or more of the above answered as YES child or youth is in a high risk group. The more YES answers, the higher the risk www.freedigitalphotos.netfreedigital Hooded Person by Ambro
Mental Health Screening Q’s • Over the past few weeks have you been having difficulties with your feelings, such as feeling sad, blah or down most of the time? • If YES – consider a depressive disorder • Apply the KADS evaluation • Over the past few weeks have you been feeling anxious, worried, very upset or are you having panic attacks? • If YES – consider an anxiety disorder • Apply the SCARED evaluation • Proceed to the Identification, Diagnosis and Treatment of Child and Adolescent Anxiety Disorders Module
Mental Health Screening Q’s • Overall, do you have problems concentrating, keeping your mind on things or do you forget things easily (to the point of others noticing and commenting)? • If YES – consider ADHD • Apply the SNAP-IV evaluation • Proceed to the Identification, Diagnosis and Treatment of the Child and Adolescent ADHD Module www.freedigitalphotos.net byBoaz Yiftach
Mental Health Screening Q’s 4. There has been a marked change in usual emotions, behaviour, cognition or functioning (based on either youth or parent report) • If YES – probe further to determine if difficulties are on-going or transitory. • Consistent behaviour problems at home and/or school may warrant referral to Strongest Families. www.freedigitalphotos.net byBoaz Yiftach
Mental Health Screening Q’s • Overall, do you have problems concentrating, keeping your mind on things or do you forget things easily (to the point of others noticing and commenting)? • If YES – consider ADHD • Apply the SNAP-IV evaluation • Proceed to the Identification, Diagnosis and Treatment of the Child and Adolescent ADHD Module www.freedigitalphotos.net byBoaz Yiftach
Next Steps … • Positive for Depression + Anxiety or ADHD • Apply KADS and protocol for Depression • After treatment, review for presence of continued Anxiety Disorder or ADHD • If continues positive for Anxiety Disorder • Refer to specialty mental health services • If continues positive for ADHD • Follow the protocol in the ADHD toolkit, OR • Refer to specialty mental health services
Psychotherapeutic Support & Non-Specific Interventions
Psychotherapeutic Support www.freedigitalphotos.net by Photostock
Non-Specific Interventions • Exercise • Sleep • Consistent Daily Routine • Positive Social Contact • Healthy Nutrition • Music & Movement • Bright Light • Avoid Drugs (including recreational drugs) www.freedigitalphotos.net by Photostock
Sleep Assessment www.freedigitalphotos.net by Graur Codrin
Kelty Mental Health Resource Centre • www.keltymentalhealth.ca • 1-800-665-1822 or Vancouver 604-875-2084
Referral Flags Refer at 3 different points • Emergency Referral (prior to treatment initiation) • Suicide ideation with intent or plan • Major depressive episode with psychosis • Delusions or hallucinations ID 837573 stockxchng
Referral Flags • Urgent Referral (treatment may be already initiated) • Usual Referral
Abuse or Neglect Concerns • Helpline for Children • 310-1234 (free – no area code required) • 24 hours/7 days • Do not have to give your name • Immediate danger • 9-1-1 or local police • Resources • Ministry of Children and Family Development • www.mcf.gov.bc.ca/child_protection • See “Handbook for Action on Child Abuse and Neglect”