Child & Youth Mental Health Screening Tools
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Visit 1 Monitor for Risk ChildChild & & Youth Youth Stop Assessment but NO Elevated f/u every 3-6 Risk? Mental Health months Mental Health YES Tools/Resouces Screen Consider other Only some explanations, MOA Tasks symptoms provide non-specific Support and/or supports and No Decrease MH Screening Questions proceed to next visit in Function Risk Identification Tables in one month Significant Elevation in Symptoms And / Or Functional Decrease in Function · TeFA Contact in 3 NO YES · Possible Teen days by CFA Depression phone, text or email Evaluation Tools: Visit 2 Referral Flags · ADHD Continue assessment and support Evaluate need throughout · Anxiety Contact in 3 involvement NO YES · Depression Possible Teen days by Emergency: Suicidal Depression phone, text intent or plan, acute · Suicide Risk or email psychosis · Substance Abuse Screen Visit 3 Urgent: Severe symptoms & · CGI Measurement Complete Assessment deterioration in function, suicidal ideation, other Non-Specific Supports major psychiatric conditions Usual: additional therapy, Safety Plan evaluation, treatment non- No continuing Unclear, severe, responders, other medicatl dysfunction or ADHD Depression Anxiety complex and concerns, med side effects, nd General Resources distress requiring support 2 or further episode Strongest Families Referral PSP Child and Youth Mental Health Module Child and Adolescent Mental Health Screening Questions Historical factors: 1. Parent has a history of a mental disorder (including substance abuse/dependence) 2. Family has a history of suicide 3. Youth has a childhood diagnosis of a mental disorder, learning difficulty, developmental disability, behavioural disturbance or school failure 4. There has been a marked change in usual emotions, behaviour, cognition or functioning (based on either youth or parent report) One or more of the above answered as YES, puts child or youth into a high risk group. The more YES answers, the higher the risk. Current situation: 5. Over the past few weeks have you been having difficulties with your feelings, such as feeling sad, blah or down most of the time? 6. Over the past few weeks have you been feeling anxious, worried, very upset or are you having panic attacks? 7. 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)? 8. Do you or others have significant difficulty managing your child's behaviour (e.g., temper tantrums, acting out, disobedience, unprovoked outbursts, physical or verbal aggression, being destructive, impulsivity, inability to sit still or focus)? If the answer to question 1 is YES – for adolescents, consider a depressive disorder and apply the KADS evaluation and proceed to the Identification, Diagnosis and Treatment of Adolescent Depression. If the answer to question 2 is YES – consider an anxiety disorder, apply the SCARED evaluation and proceed to the Identification, Diagnosis and Treatment of Child or Youth Anxiety Disorders If the answer to question 3 is YES – consider ADHD, apply the SNAP evaluation and proceed to the Identification, Diagnosis and Treatment of Child or Youth ADHD. If the answer to question 4 is YES, probe further to determine whether the difficulties are on-going or transitory. Problem behaviours that occur erratically typically do not warrant treatment. Consistent behaviour problems at home and/or school may warrant referral to Strongest Families. 24_CYMH_PSP_Mental_Health_Screening_Questions_2011_08_23 v2 1 of 2 Child and Youth Health Screening Questions (Template for Discussion) Child/Parent or Youth: "Over the past few weeks have you been having difficulties with your feelings, such as feeling sad, blah or down most of the time?" Over the past few weeks have you been feeling anxious, worried, very upset or are you having panic attacks? 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)? Parent Only: Do you or others have significant difficulty managing your child's behaviour (e.g. temper tantrums, acting out, disobedience, unprovoked outbursts, physical or verbal aggression, being destructive, impulsivity, or inability to sit still or focus)? Once completed, please give this form back to the office staff ____________________________. Screening Tools MOA’s Child & Adolescent MDD in Youth Risk Mental Health Screening Identification Table Child Functional Assessment Anxiety Disorder in Child CFA Risk Identification Table Teen Functional Assessment Anxiety Disorder in Youth TeFA Risk Identification Table Clinical Global Improvement ADHD Disorder in Child CGI Risk Identification Table Weiss Functional Impairment ADHD Disorder in Youth Rating Scale - Parent Risk Identification Table Weiss Functional Impairment Tool for Assessment of Rating Scale - Child Suicide Risk - Adolescent Weiss Functional Impairment Substance Abuse Assessment Rating Scale - Instructions PSP Child and Youth Mental Health Module MOA’s Child and Adolescent Mental Health Screening Child & Youth General Mental Health Screening Questionnaire If Answer is "Yes"to If Answer is "Yes" to If Answer is "Yes" to If answer is "Yes" to Question 4: Question 1: Question 2: Question 3: Overall, do you have problems Do you or others have significant difficulty "Over the past few weeks Over the past few weeks concentrating, keeping your managing your child's behaviour (e.g. temper have you been having have you been feeling mind on things or do you tantrums, acting out, difficulties with your anxious, worried, very upset forget things easily (to the disobedience, unprovoked outbursts, physical feelings, such as feeling or are you having panic point of others noticing and or verbal aggression, being destructive, sad, blah or down most of attacks? the time?" commenting)? impulsivity, inability to sit still or focus)? Give the patient and Give the patient and Give the patient and care giver (e.g. care giver (e.g. parent, Flag chart to notify the the KADS to parent, guardian) guardian) ADHD physician of complete while Screening questions screening questions behavioral difficulties waiting to see the for anxiety and and the SNAP-IV (18 as identified on the SCARED while waiting items) while waiting to screening questions. doctor. to see the doctor see the doctor Attach a copy of TASR-A to the clinical file if an adolescent answered YES to any of the General Mental Health Screening Questions ( To be filled out by the clinician) Since comorbidity is frequently found, some children or adolescents and/or their caregivers may respond YES to more than one question. If that is the case, provide them with the screening questions or clinical tools regarding each question. 30_CYMH_PSP_MOA_Algorithm_ 2011_08_26_v3 1 of 1 Child and Youth Mental Health PSP Module MDD in Youth, Risk Identification Table Well established and significant Less well established risk effect Possible “group” identifiers risk effect (these are not causal for MDD but may identify factors related to adolescent onset MDD) 1. Family history of MDD 1. Childhood onset Attention 1. School failure Deficit Hyperactivity Disorder 2. Family history of suicide 2. Gay, lesbian, bisexual, 2. Substance misuse and abuse transsexual 3. Family history of a mental (early onset of use including illness (especially a mood cigarette and alcohol) 3. Bullying (victim and/or disorder, anxiety disorder, perpetrator) substance abuse disorder) 3. Severe and persistent environmental stressors 4. Childhood onset anxiety (sexual abuse, physical abuse, disorder neglect) in childhood Tool - Risk Identification_Youth_Depression_2011_07_04 1 of 1 Child and Youth Mental Health PSP Module Anxiety Disorder in Children, Risk Identification Table Significant risk effect Moderate risk effect Possible “group” identifiers (these are not causal for anxiety disorder but may identify factors related to adolescent onset anxiety) 1. Family history of anxiety 1. Children with shy, inhibited 1. School failure or learning disorder and/or cautious difficulties temperament (innate 2. Severe and/or persistent personality type) 2. Socially or culturally isolated environmental stressors in early childhood 2. Family history of a mental 3. Bullying (victim and/or illness (mood disorder, perpetrator) substance abuse disorder) 3. Have experienced a traumatic event 4. Substance misuse and abuse (early onset of use including cigarette and alcohol) Tool - Risk Identification_Child_Anxiety_2011_07_04 1 of 1 Child and Youth Mental Health PSP Module Anxiety Disorder in Youth, Risk Identification Table Significant risk effect Moderate risk effect Possible “group” identifiers (these are not causal for anxiety disorder but may identify factors related to adolescent onset anxiety) 1. Family history of anxiety 1. Children with shy, inhibited 1. School failure or learning disorder and/or cautious difficulties temperament (innate 2. Childhood onset anxiety personality type). 2. Socially or culturally isolated disorder 2. Family history of a mental 3. Bullying (victim and/or 3. Severe and/or persistent illness (mood disorder, perpetrator) environmental stressors in substance abuse disorder) childhood. 4. Gay, lesbian, bisexual, 3. Experiencing a traumatic transsexual Event 4. Substance misuse and abuse (early onset of use including cigarette and alcohol) Tool - Risk Identification_Youth_Anxiety_2011_07_04 1 of 1 Child and Youth Mental Health PSP Module ADHD Disorder in Children, Risk Identification Table Significant