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Strategies, Screening and Systems of Care

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. Mental Health Screening Introduction. Need for screening Case example Screening for . . . Domestic/dating violence

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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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