TeenScreen National Center for Mental Health Checkups

Integrated Care: New Focus for Nation’s Mental Health Professionals

xadmin — Mon, 07 May 2012 16:31:17 +0000

Integrated care is far more than just a new health buzzword. Incorporating mental health into primary care is in fact “a game-changer” according to A. Seiji Hayashi, MD, MPH, Chief Medical Officer of the Bureau of Primary Health Care, Health Resources Services Administration. It is a particularly important health issue for our teens.

We’re pleased to see that the American Psychiatric Association has made integrated care a focus of its 165th Annual Meeting being held this week in Philadelphia. A special education track is giving the nation’s mental health professionals the opportunity to learn more about how to better collaborate with primary care providers.

This is not insignificant. Meeting the mental health care needs of youth demands a new set of primary care skills. Primary care providers can benefit from collaboration with mental health professionals to build these skills and bolster their confidence. But, in reality, these professionals have historically had little collaboration. The APA is making an important move to change that.

Most adolescents receive their health care at the primary care office. And while the teen years are often the most physically healthy time of life, mental health concerns are prevalent. More than 11% of U.S. children and adolescents suffer from a serious mental disorder that causes significant impairment, yet 70% are not identified and do not receive mental health services. Half of all mental disorders emerge by age 14. Left untreated, depression and mental health disorders can lead to decreased school performance, substance abuse, emotional distress, and the potential for suicide.

Stronger collaboration that supports integrated care has the potential to reverse these disturbing trends and make a significant difference in the lives of our youth. Learn more about one state’s innovative program.

Inside TeenScreen: Taking On Stigma for Today’s Teens

Laurie Flynn — Thu, 26 Apr 2012 13:56:24 +0000

Her friends may have been struggling with mental health problems, but Kelly Nadel, TeenScreen Program Associate, had no way of knowing. As a high school student in the 1990s, she remembers that mental health was never discussed — not at school, at home, nor with friends. Although mental health stigma remains an issue, there is a now greater awareness of the biological and neurological basis for many mental disorders. There is also a recognition of the prevalence of these disorders in adolescents, and the benefits of identifying and treating these problems early.

Still, stigma continues to play a role in inhibiting parents and teens from reaching out to providers, asking questions, and getting help that a teen may need.

Check our webinar, Teens & Mental Health: How to Help Families, to learn more.

“I was ready to help change that”, says Kelly. She joined TeenScreen in 2005, putting her interest in psychology and her desire to make a difference, to work.

Hear more about the journey that led Kelly to TeenScreen.

Marin County Schools Make Screening a Priority

Laurie Flynn — Mon, 23 Apr 2012 15:51:09 +0000

Budget constraints have forced many counties around the country to cut programs and services, and Marin County, CA is no exception. Still, mental health screening has remained a funding priority for schools there, and Esme Gordon, the TeenScreen Program Coordinator for the county’s Family Service Agency, knows why.

Marin school districts and boards of education understand the value of TeenScreen, she says, and find the funds to implement the program in their high schools.

“During these times of severe financial cutbacks in funding, our local schools have found the funds to bring TeenScreen to their campuses,” she says.

In fact, the number of TeenScreen programs has grown from two in 2008 to five currently, says Esme, and a San Francisco high school has requested a screening program be implemented later this year.

“The success of TeenScreen in the original schools we screened in has strongly motivated other schools to bring the programs to their campuses,” she said.

Read one’s students remarkable story of Marin County’s first TeenScreen program.

Hear more from Esme about how Marin uses TeenScreen to ensure that “young people who may be falling through the cracks get the help they so desperately need.”

Why Kaiser Permanente Southern Colorado Believes in Teen Mental Health Screening

Richard Spurlock MD MBA — Wed, 18 Apr 2012 19:41:53 +0000

Richard Spurlock, M.D. MBA is the Medical Director at Kaiser Permanente Southern Colorado

As a not-for-profit health plan, Kaiser Permanente has long been committed to addressing community health issues. As we confronted the growing adolescent suicide rate in Southern Colorado several years ago, the need to address the problem took on a sense of urgency. From 2003-2007, Colorado had the second highest suicide rate in the U.S for youth ages 10-19 (6.8 per 100,000). In 2009, our region of El Paso, County — which includes Colorado Springs — had an alarming youth suicide rate of 12.9 per 100,000.

Given the depth of the problem, we knew we had to take action for the community at large, not just for our members. Adolescent mental health problems are a strong risk factor for suicide, and mental disorders can have enormous implications for a teenager’s life. Left untreated, these conditions can lead to school failure, substance abuse, juvenile delinquency, and relationship difficulties with peers and families. Depression and other mental health disorders can continue into adulthood, placing a debilitating and expensive health burden on the individual and society.

We identified an opportunity to partner with our affiliate network primary care providers, our behavioral health care partner, ValueOptions, and the TeenScreen National Center at Columbia University. We introduced the TeenScreen program on a local basis, piloting in May 2009 and rolling out the program in 2010.

The results have been positive on all fronts. TeenScreen told us that teenagers would respond honestly to the questionnaire, and they were right. The vast majority of our providers — 95% — say that screening has helped them uncover mental health concerns that they might otherwise have missed. Even if the screening is negative, the results of the questionnaire provide an important opportunity for critical dialogue between teens, parents, and providers. If a Kaiser Permanente teen member is screened and potential problems are identified, families and providers are connected to ValueOptions immediately for a full mental health evaluation with a qualified mental health professional. Other teens are directed by their physicians to mental health providers and resources in the community. By 2010, the teen suicide rate in El Paso County had dropped by half to 6.3 per 100,000. I believe our work contributed to that decrease.

Our TeenScreen program has gained regional and national recognition. It was nominated for a Kaiser Permanente CARE award and for the company’s prestigious James A. Vohs national award. These awards are gratifying, but what is most important is that we have made a difference.

Teen suicide is absolutely a preventable issue and teens should get the mental health care they need. We would encourage all physicians that care for teens to embrace adolescent mental health screening and work with TeenScreen National Center to make it happen.

Revolutionizing Teen Mental Health Care: Our Next Webinar

Laurie Flynn — Mon, 16 Apr 2012 20:21:18 +0000

I first wrote about headspace in the fall of 2011, only a few days after I had the pleasure of meeting Chris Tanti. As CEO of headspace, he manages what I think is one of the most innovative and effective teen mental health programs in the world.

headspace shares our mission of early identification and treatment of mental illness and teen suicide prevention. It was a goal of mine to meet Chris in person, and importantly, to introduce him to some of our faculty at the Columbia University Division of Child and Adolescent Psychiatry. I am so pleased that Chris will be the speaker at our April 26 webinar — headspace: What can we learn from Australia’s mental health success?

The webinar will give many more people the opportunity learn how this six-year old program is successfully addressing the dual problems of stigma and mental health access in Australia. Through a network of 40 innovative centers, headspace offer teens a comfortable place to talk about what’s on their minds — from general health problems, to school difficulties, substance abuse, unemployment, and other common concerns of adolescence.

Youth can stop by, drop in or access information online and then make a connection with headspace in their community. At the same time, an integrated care model ensures that primary care providers and professionals who work with youth get the mental health skills they need to identify potential problems and link teens to care.

It’s both a simple idea and one that is revolutionizing adolescent mental health care throughout Australia. Join us for an exciting event that will challenge our thinking on mental health care and access, and provide a fresh perspective on meeting the growing mental health needs of our youth.

Providers: Concerned you lack mental health skill? That’s No Excuse

Patricia Jackson Allen MS RN PNP FAAN — Wed, 11 Apr 2012 20:06:08 +0000

What do I do if I get a positive result from a teen mental health screening? It’s a question I get from my primary care colleagues when discussing the important role that we can play in reducing the impact of adolescent mental disorders.

A mental health questionnaire can elicit responses that identify possible problems: depression, anxiety disorder, substance use disorder or suicidal thoughts or attempts — conditions that are best treated early.

A mental health screen can be an effective and accurate tool, and yet some primary care providers still avoid them. They’re concerned that their training hasn’t prepared them to address mood or behavioral problems. They may not be familiar with mental health services in their area. If they encounter a positive score, they may be unsure of what to do next. These are valid concerns and deserve careful consideration. But, they are not an excuse to avoid screening. The prevalence of these disorders are too high, and the symptoms too debilitating to omit screening from the adolescent check-up.

More than 11% of U.S. children and adolescents suffer from a serious mental disorder that causes significant impairment, yet 70% are not identified and do not receive mental health services. Half of all mental disorders emerge by age 14. Left untreated, depression and mental health disorders can lead to decreased school performance, substance abuse, emotional distress, and the potential for suicide. Conversely, treatment success rates range from 60-80%.

Primary care providers need to ask themselves: Would you avoid screening for developmental delays even though you’re not a neurologist? Would you decide against lead poison screenings because you’re not a hematologist? Most providers would look askance if you suggested such things.

Screening is far and away more effective than asking teens open-ended questions in a psychosocial interview. Research has shown that screening can be significantly more accurate than the informal interview method – which may miss about 50% of at-risk teens.

While it is certainly true that we need to supplement our primary care training, we are grounded in the management of pediatric chronic disease. Working with specialists, we co-manage asthma, diabetes, neurological disorders and other serious illnesses. We are well-positioned to be on the front lines of teen mental health.

There are numerous resources – from NAPNAP, TeenScreen National Center, the American Academy of Pediatrics and others — readily available to assist primary care providers in improving their skills and knowledge about adolescent mental health, treatment, community resources, motivational interviewing, cognitive behavioral therapy, and pharmacotherapy.

When primary care providers make teen mental health a priority, they’re often impressed by the frequency of positive results, and surprised at how they would not have detected a problem otherwise.

Meeting the Challenges of Urban Teens

Laurie Flynn — Tue, 10 Apr 2012 14:36:12 +0000

The stigma associated with mental illness runs deep in her community. Magally Prosper, MD, a private practice pediatrician in Brooklyn, NY., began screening three years ago after learning of TeenScreen National Center resources at a professional conference. She confronts daily the intricate task of meeting the growing mental health needs of teens in a largely Hispanic, Haitian and Caribbean community.

Stigma is universal, but it may be particularly damaging in immigrant and urban communities. Recent findings from the Centers for Disease Control and Prevention (CDC) show that nearly one in seven Latino teens in New York City attempted suicide in 2009 and an even greater number, one out of five, in Brooklyn.

“In my Caribbean culture, mental illness is not something that we talk about,” she said. “Seeking counseling is taboo.”

But adolescent mental health screening has made a difference. Hear more from Dr. Prosper on the challenges facing urban teens, and how screening has helped uncover mental health problems and open a dialogue with teens and families.

Helping Depressed, Anxious Teens: Primary Care’s Unique Role

Laurie Flynn — Thu, 05 Apr 2012 16:08:52 +0000

The process may be challenging, but primary care providers incorporating depression and anxiety treatment into their adolescent practice have a “wonderful opportunity” to support families and make an important difference in the lives of teens.

Those were the opening thoughts from adolescent mental health expert Jefferson Prince, MD, an instructor in psychiatry at Harvard Medical School and director of child psychiatry for the North Shore Medical Center in Salem, MA. Dr. Prince took on the issues of adolescent mental health in primary care with more than 250 providers who attended our webinar What Can I Do With All the Depressed or Anxious Teens in My Practice?: Practical Strategies for the Primary Care Provider.

In an engaging and supportive discussion, Dr. Prince told providers that their longstanding relationships with teens and their parents can increase receptivity to screening, diagnosis and treatment. They can open the dialogue, let teens and parents know that depression and anxiety are common and give the family hope that the situation can improve. Importantly, providers can help parents “navigate the dilemma of medication” and work as partners in helping their teen feel better.

Through a comprehensive review of current treatment strategies, Dr. Prince also offered his insights on efficacy, side effects, tapering, and the role of complementary therapies. But, he also emphasized the need for providers to seek help when they too need it – accessing resources, referring, and calling on parents to share the responsibility.

“As you try to process all that the families bring, it can be very rewarding to treat (teens) and see them get well,” he said. “But, never worry alone. Share the burden with your colleagues.”

Listen to the webinar here.

Teens and Substance Abuse: What Do Schools Need to Meet the Challenge?

Deanna Richards — Tue, 03 Apr 2012 18:52:41 +0000

One of the most gratifying aspects of my job as TeenScreen’s Schools and Communities program manager is meeting with school mental health personnel who share our commitment to youth. I am always impressed with the vigor and dedication of these professionals, particularly during times of budget constraints.

One area of growing concern is the abuse of both prescribed medications and illegal substances among young people. Recent reports show a sharp increase in the use of some illegal substances among teenagers, and a report from the federal Substance Abuse and Mental Health Services Administration (SAMHSA) found that one in three youth ages 12 and older developed a substance use disorder with prescription painkillers.

We know from research that that there is a strong link between substance abuse and mental health problems. Young people who suffer from depression are three times more likely to abuse drugs than those without depression. And, substance abuse can actually increase the risk of developing a mental disorder.

Teens with substance abuse disorders are at a higher risk of dropping out of school, getting involved in criminal activity, and of accidental death. They can become chronic; youth who become addicted tend to struggle with the problem throughout their lives.

The mental health professionals who work in schools know the issues, but they also know that making a difference is challenging. Mental health problems and substance abuse can be difficult for parents to detect and teens are rarely forthcoming.

School mental health professionals tell me they see a solution in greater communication with family and other health providers so that the school can properly support students. And we agree. TeenScreen can often play a role in providing vital information about a teen’s mental health to parents and providers. Many schools around the country work with our program to help facilitate awareness and openness.

By identifying mental heath concerns early on, we can potentially avoid an escalating substance abuse problem, or detect substance abuse outright and work with teens, parents and professionals to get teens the help they need.
The more school psychologists and other professionals in the field can create venues for schools, teens, families and community members to communicate with one another, the better the outcome for everyone involved. TeenScreen welcomes the opportunity to be a part of this effort.

TeenScreen in Primary Care: Getting a Clearer Picture of Teen Health

Laurie Flynn — Mon, 02 Apr 2012 15:03:04 +0000

Primary care providers are often surprised by the results they get after offering an adolescent a mental health screening. Gary Mirkin, MD, a pediatrician at MDs4kids Medical in Great Neck, NY, (a division of Allied Pediatrics, one of the largest multi-center private pediatric practices in the country) is among them.

Dr. Mirkin had always asked a series of psychosocial questions to teens and pre-teens during the office visit. But the answers were decidedly different – and less meaningful — than those elicited from a validated screening questionnaire.

“I would typically ask how things were going with school, friends and social life,” he said, “and I would typically get the same answer from patients and their parents: ‘Fine’. When I started screening, I was amazed at the results I started getting. I found out that not only were some of my patients suicidal, but that they had been thinking about it for several years.” In addition to suicide, he said screening also revealed more depression risks.

“If I hadn’t started using TeenScreen I would not have picked these problems up,” says Dr. Mirkin. “The screen makes it easier for the patient to respond and offers an ice-breaker to open a dialogue.”

Hear more of Dr. Mirkin’s insights on teen mental health, the value of screening, and practical issues for primary care providers.