Topics
What's New (updated 7-24-08)
The Mental Health of Adolescents: A National Profile, 2008
The National Adolescent Health Information Center (NAHIC) at the University of California, San Francisco (UCSF) is pleased to announce the release of its first brief on mental health, entitled The Mental Health of Adolescents: A National Profile, 2008. Adopting a comprehensive approach to mental health, this brief presents national data on measures ranging from well-being to substantial impairment. This brief aims to inform health professionals, policymakers, educators, administrators, and school-based health centers concerned with the health and well-being of adolescents.
Bipolar Teens Are at Greater Risk of Substance Abuse
New research from the Massachusetts General Hospital confirms that teens with bipolar disorder are at greater risk of substance abuse. Therefore teens with bipolar disorder should be carefully screened for smoking and substance abuse, and teens with known substance abuse problems should be screened for bipolar disorder.
AD/HD and Teens: Information for Teens
According to the National Resource Center on AD/HD, teens with Attention Deficit/Hyperactivity Disorder (AD/HD) experience a higher level of conflict with their parents and experience other changes of adolescence more pronouncedly than other teens. This information sheet is a resource for teens to help them navigate these changes more smoothly.
Disparities in Treatment May Lead to an Increase in Minority Presence in Foster Care
A new report featured in the Los Angeles Daily News detailed in Some health care officials maintain that the high population of minority children in the foster care system can be attributed in part to hospitals and welfare agencies disproportionately administering drug tests to low-income, pregnant, minority women who seek public health care. The report states that, nationwide, 58% of the 513,000 children in foster care are minorities, although they comprise only 42% of the U.S. child population, according to the Daily News.
[top]
Cultural and Linguistic Competence (CLC) and Disparities
The resources below represent a small number of the excellent resources that are also contained in the Cultural and Linguistic Competence Implementation Guide, available on the Technical Assistance Partnership new Cultural and Linguistic Competence Web site at http://www.tapartnership.org/cc/default.asp.
Recruitment and Retention of a Diverse Workforce
The Power of Diversity: Supporting the Immigrant Workforce
This very detailed curriculum helps administrators and other agency staff find, support, and retain an immigrant workforce that is reflective of the population of focus. It includes a Facilitator’s Guide and a Learner’s Guide (workbook) and is meant to train frontline supervisors of community based services. The curriculum addresses issues, challenges, and benefits of a new immigrant workforce. Supervisors and other readers can gain skills and knowledge about how to effectively manage a diverse workforce.
Cultural and Linguistic Competence Coordinator Job Descriptions
Among the most frequently asked for resources are cultural and linguistic competence coordinator job descriptions. Below are two job descriptions and one description of an office of multicultural affairs. These are just a sample of the many that are used.
Training and Supervision
And the Journey Continues: Achieving Cultural and Linguistic Competence in Systems Serving Children and Youth with Special Health Care Needs and Their Families
This monograph provides insights on implementing cultural and linguistic competence in organizations addressing maternal and child health. It highlights experiences in infusing cultural and linguistic competence into the policies, structures, and practices of selected state programs. The monograph, developed by the National Center for Cultural Competence (NCCC) at Georgetown University with support from the Maternal and Child Health Bureau, presents stories collected from 23 Title V Children with Special Health Care Needs programs. Also included are key lessons that NCCC faculty, staff, and consultants have learned about providing program guidance, as well as an analysis of the various aspects of linguistic and cultural competence described in each State's story. A list of references and State and territorial contacts is included.
The Future of the Hispanic Family
"For most Latinos, families are made and broken amid transformations in culture, economic footing, civic status, and identity," according to the Brookings Institution. Brookings' Center on Children and Families and the Annie E. Casey Foundation are hosting a forum to discuss trends in marriage and childbearing in the Hispanic community, and to address what actions policymakers and practitioners can take to strengthen Hispanic families and improve the well-being of children in these families.
Promoting Cultural Diversity and Cultural Competency (PDF)
This self-assessment checklist was created for personnel who provide services and supports to children with disabilities and special health needs and their families. It is applicable for personnel who work with children in the mental health system. This brief, yet comprehensive, self-assessment instrument covers: physical environment, materials, and resources; communication styles; and values and attitudes.
Cultural Competency Survey for Mental Health Professionals (PDF)
This self survey, developed by the Asian American Family Counseling Center of Houston, Texas, is an excellent resource for systems of care that work specifically with Asian Americans and Pacific Islanders (AAPI). It consists of probing questions intended to help mental health practitioners assess the strengths and weaknesses of their cross-cultural counseling skills and training needs. The survey document also contains several appendices that cover intergenerational conflicts, stages of grief or acculturation, questions to ask AAPI immigrant clients, stress management and others.
Building Culturally and Linguistically Competent Services to Support Young Children, Their Families and School Readiness (PDF)
This is an excellent “Tool Kit” that focuses on diversity and the cultural context of the family and community; addresses the impact of culture on child development and implementing culturally and linguistically competent services; as well as strategies for staff to implement these services. It includes critical questions for communities to address; key strategies to implement; guides, tip sheets and checklists and promising practices.
[top]
Early Childhood
In addition to the resources here, more can be found on the Early Childhood Community of Practice Web page at http://www.tapartnership.org/Earlychildhood/default.asp.
Preschoolers Benefit from Mental Health Screening (PDF)
A new study from the FPG Child Development Institute demonstrates that preschoolers can benefit by a simple and inexpensive mental health screening process designed to flag potential signs of more serious problems. The study highlights the development of ABLE—a screening tool to identify young children with self-regulation problems with attention.
Early Childhood Health Problems and Prevention Strategies: Costs and Benefits (PDF)
A new issue brief from Partnership for American Economic Success examines the costs of four specific types of young children’s health problems: exposure to tobacco smoke, unintentional injury, mental health problems, and obesity. It also reviews over 300 studies of a range of interventions to address these problems. While results vary for each health issue, the brief concludes that investing in early childhood health makes economic sense.
New “Ask the Experts” Feature and “Partner Page”
The Promising Practices Network (PPN) has launched a new "Ask the Experts" feature, as well as a new “Partner Page” for the Fred Rogers Center for Early Learning and Children’s Media. The “Ask the Experts” feature allows you to ask three leading child policy experts your questions on the topic of videos and television programming for children under two years old. On the new Partner Page you can find information and resources on the Center's priority issues, including media and its influence on early learning and child development, baby and infant television and videos, and guidelines for young children's media use.
Children's Mental Health Briefing Book (PDF)
The Briefing Book, developed by Florida's Children First, is a web-based "notebook" which contains a collection of recommendations, articles, reports and public records concerning children's mental health needs.
Manual Provides Guidance in Choosing Pediatric Developmental Screening Instruments
Pediatric Developmental Screening: Understanding and Selecting Screening Instruments informs practitioners' selection and application of screening instruments in a range of practice settings. The Web-based manual, developed by the Commonwealth Fund, is based on a review of the scientific research on available developmental screening instruments.
Maternal Depression as a Risk Factor Affecting Child-wellbeing and School Readiness
The issue brief, Reducing Maternal Depression and Its Impact On Young Children: Toward a Responsive Early Childhood Policy Framework, provides an overview of why it is important to address maternal depression as a central part of the effort to ensure that all young children enter school ready to succeed. The issue brief is jointly published by Project THRIVE and Pathways to Early School Success at the National Center for Children in Poverty (NCCP). The brief is based on a meeting to identify and promote solutions to emerging issues that impact young children's healthy development and school readiness. State and federal policy responses, recommendations, and a conclusion are also presented.
State & Community Policy Roundup: Progress on Infant-Toddler Issues Across the Country (PDF)
Every six months, ZERO TO THREE provides a synopsis of innovative policy activities that support the healthy development of infants, toddlers and their families. The December 2007 edition covers everything from early learning guidelines and quality rating systems to the unionization of home-based child care providers and increases in State funding for infant-toddler services.
Early Childhood Mental Health Consultation: An Evaluation Tool Kit (PDF)
The Early Childhood Mental Health Consultation (ECMHC) Evaluation Tool Kit, developed by the Georgetown University Center for Child and Human Development (GUCCHD), is for States, communities, agencies and programs investing in early childhood mental health consultation and committed to quality data. It is a web-based resource that combines a brief review of the literature and current research addressing the effectiveness of early childhood mental health consultation with guidance for designing and implementing program evaluation. It will help States, communities, and programs increase their capacity for high-quality evaluation of early childhood mental health consultation in community-based settings.
Developmental Screening Tools: Gross Motor/Fine Motor for Newborns, Infants and Children
According to a Behavioral and Developmental Pediatrics Online article, “child development is a dynamic process and estimation of developmental status only by clinical impression makes the diagnosis inaccurate.” The article’s authors state that it is important for physicians to assess all aspects of history and physical examination, especially in infants and children and contend that the advantages of formal screening instruments include that they: explicitly state the guidelines for normal development; serve as reminders for observations; and help record keeping and identifying children with delays. Further, they assert that the disadvantages include the time involved to complete a full evaluation and the consistency of administering the test.
Authors Investigate Stress and Coping Among Mothers of Very-Low-Birthweight (VLBW) Children at Age Eight
Although a wide range of outcomes of VLBW births has been studied, the authors of this report argue that little attention has been paid to parental adaptation to VLBW birth beyond the neonatal period. Understanding the nature, scope, and determinants of stress and coping in families of VLBW children, the report claims, can lead to interventions to reduce stress and improve child outcomes. In the report, the authors compare severity and determinants of stress and coping in mothers of 8-year-old VLBW and term children with varying degrees of medical and developmental risk. The authors conclude that "advances are needed to address maternal and family issues to ensure the long-term optimal outcome for VLBW infants and their families."
Healthy Steps for Young Children: Sustained Results at 5.5 Years
The Healthy Steps Program, an intervention that builds relationships between parents, children and pediatric practices, succeeds in conferring long-term benefits to participants, even after the program has ended, according to a new study from the Johns Hopkins Bloomberg School of Public Health. Benefits include: increased satisfaction among parents with their child’s health care, increased reading among children, and increased chances that parents report behavioral problems to health care providers.
Building Culturally and Linguistically Competent Services to Support Young Children, Their Families and School Readiness (PDF)
This is an excellent “Tool Kit” that focuses on diversity and the cultural context of the family and community; addresses the impact of culture on child development and implementing culturally and linguistically competent services; as well as strategies for staff to implement these services. It includes critical questions for communities to address; key strategies to implement; guides, tip sheets and checklists and promising practices.
Center on the Social and Emotional Foundations for Early Learning (CSEFEL) “What Works Briefs”
This series of briefs summarize effective practices for supporting children's social-emotional development and preventing challenging behaviors. Each brief describes practical strategies, provides references to more information about the practice, and includes a one-page handout that highlights the major points of the brief.
CSEFEL Training Modules
These modules were designed based on input gathered during focus groups with program administrators, TA providers, early educators, and family members about the types and content of training that would be most useful in addressing the social-emotional needs of young children. The content of the modules is consistent with evidence-based practices identified through a thorough review of the literature.
Center for Evidence-Based Practice: Young Children with Challenging Behavior
The following are handouts for professionals and family members regarding information on evidence-based recommendations:
For additional related resources, visit http://challengingbehavior.fmhi.usf.edu/resources.html.
National Center for Children in Poverty Briefs
This series of issue briefs speak about the need to meet the needs of children early in their lives:
For additional related resources, visit http://www.nccp.org/index.html.
Frequently Asked Questions
Question: What are the consequences of behavior problems in young children?
Answer: The promotion of mental health and wellness, as well as the prevention of mental health disorders, are primary messages from the President’s New Freedom Commission on Mental Health. One reason for these messages is that we know what happens when behavior problems in early childhood are not addressed. Read the full response here.
Additional Early Childhood Resources
[top]
Evidence-based Practice and Practice-based Evidence
State Implementation of Evidence-Based Practices
Bruns, E. J., & Hoagwood, E. K. (2008). State implementation of evidence-based practice for youths, Pt. I: Responses to the state of the evidence, Journal of Child and Adolescent Psychiatry, 47(4), 369-373.
Bruns, E. J., Hoagwood, E. K., Rivard, J. C., Wotring, J., Marsenich, L., & Carter, B. (2008). State implementation of evidence-based practice for youths, Pt. II: Recommendations for research and policy, Journal of Child and Adolescent Psychiatry, 47(5), 499-504.
In these two columns, Bruns and colleagues discuss ways that states are playing a role in the implementation of evidence-based practices for children with emotional and behavioral problems and their families. The authors find that there is not a single, clear pathway to the successful adoption of these interventions at the state level. Rather, states are beginning to implement EBPs in ways consistent with their particular needs, goals and constraints.
Read more about these columns. (PDF)
Evidence-Based Services Biennial Report
What services and supports work? The mental health field is always looking for evidence-based practices and practice-based evidence to incorporate into systems of care. Many know that Hawaii’s Department of Health, Child and Adolescent Mental Health Division (DHCAMHD) has done ground breaking work in this area. Each year their Evidence-Based Services Committee issues a Biennial Report. Diagnostic categories covered in the report include: attention and hyperactive problems; anxiety, phobia and avoidance behavior; autism, anorexia, bulimia, depression, oppositional behavior, conduct problems, delinquency and substance use.
State Mandate for the Use of Evidence-Based Practices (EBPs)
In 2003 the Oregon State Legislature passed ORS 182.525 (Senate Bill 267). This bill requires that, beginning in 2005, State funds be spent incrementally on Evidence-Based Practices. Oregon’s Office of Mental Health and Addiction Services (OMHAS) is responsible for implementing the initiative. Between 2005 and 2007, 25% of State funds for mental health and addiction services, including prevention monies, will be spent on EBPs. The percentage increases to 50% in 2007-09 and to 75% by 2009-11.
Resource Guide for Promoting an Evidence-Based Culture in Children’s Mental Health
The Substance Abuse and Mental Health Services Administration (SAMHSA), in conjunction with the National Association of State Mental Health Program Directors Research Institute (NRI) as well as many other writers and editors from throughout the field, developed the Resource Guide. Below is the table of contents from the Guide that is located on the SAMHSA Web site that provides an outline of what the Guide contains and its potential usefulness for working with evidence-based treatments and practices and practice-based evidence.
Click on any topic below to go to that section of this Resource Guide. You can also visit other sections by clicking on the section icons to the left or the top of the screen.
New Spanish Publication Gives Evidence-Based Parenting Guidelines
The National Institutes of Child Health and Human Development (NICHD) has released “¿Qué Significa ser Padres?,” a Spanish-language version of their “Adventures in Parenting” booklet. The booklet offers parenting strategies based on scientific research that can be used for children of any age. It also provides practical suggestions for successful parenting that parents can adapt for their own lives and situations. It also includes real-life examples of how some parents have incorporated these strategies into their day-to-day parenting activities.
Frequently Asked Questions
Question: What is practice-based evidence?
Answer: You have probably heard reference made to “Practice-Based Evidence” but did not know exactly what it is. One definition comes from the Monograph entitled, “The Road to Evidence: The Intersection of Evidence-Based Practices and Cultural Competence in Children’s Mental Health” (PDF) Isaacs, M.R., Huang, L.N., Hernandez, M., Echo-Hawk, H., December 2005. This FAQ also follows our October Webinar entitled, “The Intersection of Evidence-Based Practices and Cultural Competence Within Your System of Care” which discussed the partnership that should exist among evidence-based practices, practice-based evidence, cultural adaptations to evidence-based practices and cultural competence. Read the full response here.
Question: What evidence based practice(s) should we use in our system of care?
Answer: What a complicated question at many different levels. I can assure you, it is not an easy challenge to meet. Many questions need to be answered before taking an evidence based practice “off the shelf” and implementing it. Let’s start at the beginning. Read the full response here.
Question: What is the difference among Empirically Supported Treatments (ESTs), Evidence Based Treatments (EBTs), Evidence Based Practice (EBP), Cultural Adaptations, Practice Based Evidence (PBE) and Community Defined Evidence (CDE)?
Answer: We are inundated with acronyms on a daily basis. Many are confusing. There are no more confusing acronyms than those used to describe "evidence" in our interventions and practices. This will be an attempt to clarify the terms by making important distinctions among them if they exist and provide guidance about the potential pitfalls. Read the full response here.
[top]
Financing and Insurance
Towards Better Behavioral Health for Children, Youth and Their Families: Financing That Supports Knowledge
This working paper is the third in a series titled Unclaimed Children Revisited produced by the National Center for Children in Poverty, and it provides an overview of sources of funding (and their policy roots) that underwrite children’s behavior health services, illuminating the flaws and prospects of various policy choices. Although the paper focuses on public funding for mental health and on substance abuse services within the behavioral health arena, it also addresses related funding in education, child welfare, and juvenile justice. Topics include an overview of children's behavioral services, an overview of federal behavioral health funding streams and their impact, fiscal innovation in states and local communities, and challenges and opportunities. The authors conclude the paper with recommendations for policy actions to create and sustain a supportive federal and state fiscal environment.
New SCHIP Bill passes the House
Following the President's veto of the previous bill, the House has created a new bill which caps the eligibility at 3 times the federal poverty rate, and makes it clear that illegal immigrants do not qualify. Read more about the bill on the Zero to Three Web site, or on the Center on Budget and Policy Priorities Web site.
Federal Funding Sources and Promising Financing Strategies
Two Finance Project publications can give you the scoop on federal funding sources and promising strategies to finance mental health supports and services for children and adolescents exposed to traumatic life events.
- Finding Funding: A Guide to Federal Sources for Child Traumatic Stress and Other Trauma-Focused Initiatives (PDF) highlights federal funding sources to support a range of child trauma interventions.
- Thinking Broadly: Financing Strategies for Child Traumatic Stress Initiatives (PDF) presents a framework and principles to guide the selection of financing strategies for interventions aiding traumatized children and adolescents.
Preliminary Thoughts on Restructuring Medicaid to Promote Adolescent Health (PDF)
Adolescents are an underserved population in Medicaid. Research shows that their early periodic screening, diagnosis, and treatment (EPSDT) screening rates are low and States' preventive care requirements for them are weak. Additionally, payment policies discourage preventive counseling and the delivery of integrated physical and behavioral care in primary care sites. This issue brief proposes an enhanced set of health promotion and primary care benefits designed specifically for adolescents that can be offered through EPSDT or as an alternative benefit package under the Deficit Reduction Act. It also suggests possible changes to payment policies to support comprehensive preventive and primary care service delivery for adolescents.
Expanding Health Insurance Coverage and Promoting Health Care Equity
- State Strategies to Expand Health Insurance Coverage: Trends and Lessons for Policymakers
By Alice Burton, M.H.S., Isabel Friedenzohn, M.P.H., and Enrique Martinez-Vidal, M.P.P., State Coverage Initiatives, AcademyHealth
- Closing the Divide: How Medical Homes Promote Equity in Health Care: Results From The Commonwealth Fund 2006 Health Care Quality Survey
By Anne C. Beal, M.D., M.P.H., Michelle M. Doty, Ph.D., Susan E. Hernandez, Katherine K. Shea, and Karen Davis, Ph.D.
Addressing the Needs of Young Children in Child Welfare: Part C – Early Intervention Services
Created by the Child Welfare Information Gateway, this bulletin provides information about the enactment of Part C referral provisions in the Child Abuse Prevention and Treatment Act (CAPTA) and the Individuals with Disabilities Education Improvement Act of 2004 (IDEA). It also provides examples of State implementation of the new referral provisions, and gives strategies to address potential barriers.
State Children's Health Insurance Program (SCHIP) Resources
Federal SCHIP Resources
The U.S. Department of Health and Human Services Centers for Medicaid and Medicare Services (CMS) offers extensive information about the current state of the State Children's Health Insurance Program.
State SCHIP Resources
Additional SCHIP Resources
Rural Children Increasingly Rely on Medicaid and State Child Health Insurance Programs for Medical Care Report (PDF)
Frequently Asked Questions
Question: How do we sustain services, supports and training after our Cooperative Agreement ends?
Answer: Sustainability is something to begin planning for during the first year of your Cooperative Agreement. It is never too soon. There are certain "rules of thumb" to remember as you plan for sustainability of your service/support delivery system. Read the full response here.
[top]
Mental Health and Substance Abuse
The Mental Health of Adolescents: A National Profile, 2008 (PDF)
Although the research remains incomplete and limited, the evidence presented in this report supports some conclusions about adolescent mental health, including:
- One in five adolescents experience significant symptoms of emotional distress and nearly one in ten are emotionally impaired;
- The most common disorders among adolescents include depression, anxiety disorders and attention-deficit hyperactivity disorder and substance use disorder.
Development of a Screening Tool to Identify Adolescents Engaged in Multiple Problem Behaviors: The Adolescent Risk Behavior Screen (ARBS)
The Adolescent Risk Behavior Screen (ARBS) holds promise as a useful clinical tool for adolescent health care providers. It can quickly and accurately identify multi-problem teens engaged in dangerous high-risk activities that are likely in need of more comprehensive evaluation and intervention.
Active Minds on Campus
Active Minds is a student-run program that addresses the stigma surrounding mental illness among college students. Started in 2001 at the University of Pennsylvania, Active Minds has worked to expose and reduce stigma associated with mental illness within college environments.
Health Families New York’s Effective Home Visiting Program
An updated summary for Healthy Families New York (HFNY) was recently posted to the RAND Corporation's Promising Practices Network (PPN) Web site. HFNY is a community-based prevention program that seeks to improve the health and well-being of children by delivering intensive home-visiting services to expectant parents and to parents with an infant ages 3 months or younger who is considered to be at high risk for child abuse and neglect. The study on which the updated program summary was based found that this "proven" program continued to reduce child abuse and neglect in the second year of the study. The study is noteworthy because it is one of the few evaluations of home-visiting programs that have used a rigorous randomized control design. Additionally, it is the only study of a program using the Healthy Families America guidelines that meets PPN study design criteria, and it finds significant and sizeable effects at a much lower cost than models that rely exclusively on nurses.
2007 Biennial Report: Effective Psychosocial Interventions for Youth With Behavioral and Emotional Needs (PDF)
An update of the Hawaii Department of Health Task Force for Empirical Basis to Services’ Child and Adolescent Mental Health Division (CAMHD) review of scientific literature about interventions, services and medications for youth with significant emotional or behavioral needs has been released. Originally released in 2000, previous updates were published in 2002 and 2004.
Starting Early to Fix the Achievement Gap
Recently released research from RAND shows that the educational achievement gap begins at the “starting gate,” when kids who have not attended preschool first enter their kindergarten classrooms without knowing their letters, sounds, shapes, colors or numbers. According to a recent article in the Sacramento Bee, research also indicates that children who have not gone to preschool often lack basic social skills, as well, such as playing cooperatively with others or caring for themselves and their belongings. This school readiness gap mirrors the achievement gap in later grades; students who start school behind tend to stay behind.
Information and Resources for Families of Children with Health and/or Mental Health Care Needs
A new booklet from the HSC Foundation, in partnership with George Washington University's Graduate School of Education and Human Development, offers help to parents whose children have health or mental health care needs. Available online and in hard copy, and in English and Spanish, the booklet provides information about resources parents can use to build a partnership with their children's schools. For more information please visit the Web site.
Blueprints for Violence Prevention’s System of Care Intervention Programs
The following information comes from the Center for the Study and Prevention of Violence (CSPV) Web site at the University of Colorado at Boulder. The CSPV designed and launched a national violence prevention initiative to identify effective violence prevention programs. The project, called Blueprints for Violence Prevention, has identified 11 prevention and intervention programs that meet a strict scientific standard of program effectiveness. The 11 model programs, called Blueprints, have been effective in reducing adolescent violent crime, aggression, delinquency, and substance abuse. Another 18 programs have been identified as promising programs. Blueprints has evolved into a large-scale prevention initiative, both identifying model programs and providing training and technical assistance to help sites choose and implement a set of demonstrated effective programs with a high degree of integrity.
Four of the 11 prevention programs that are also intervention programs and could be utilized by System of Care Communities are:
To access the full list of programs, visit http://www.colorado.edu/cspv/blueprints/model/overview.html.
Tunnels and Cliffs: A Guide for Workforce Development Practitioners and Policymakers Serving Youth with Mental Health Needs (PDF)*
Developed as part of the U.S. Department of Labor’s Office of Disability Employment Policy’s (ODEP’s) work to help workforce development administrators and practitioners increase their understanding of youth with mental health needs and the supports necessary to help them transition into the workforce successfully. In addition, it provides policymakers, from the program to the state level, with information to help them address system and policy obstacles in order to improve service delivery systems for youth with mental health needs.
*Please note: This is a large document; download time will be longer for users with slower connections.
ABCD Toolbox: Resources for states seeking to enhance the delivery of early childhood development services (PDF)
This document is a compendium of resources to assist states seeking to strengthen the early childhood development services provided through Medicaid.
Key Measurement Issues in Screening, Referral, and Follow-Up Care for Young Children’s Social and Emotional Development (PDF)
This report is designed to assist States in assessing the effectiveness of their efforts to strengthen mental health services for very young children. The paper is an outgrowth of the work being conducted by the five states involved in the ABCD II Consortium, a project of National Academy for State Health Policy and the Commonwealth Fund that seeks to improve the delivery of services needed by very young children to ensure their healthy mental development. All five States needed reliable and valid measures to inform implementation efforts and ongoing program evaluation. This technical report, based on the work of the ABCD II States, is meant to provide tips and tools to other States interested in undertaking similar work and facing similar financial and data constraints.
Supporting Healthy Relationships Between Young Children and Parents: Lessons from Attachment Theory and Research (PDF)
According to attachment theory and research, early child-parent relationships lay the foundation for children's later social, emotional and school functioning. This new brief from the Center for Child and Family at Duke University examines the range of attachments and their importance for later development and offers guidelines and curricula recommendations for practitioners, policymakers, parents and others.
Mental Health and Substance Abuse Screening Instruments (PDF)
For an overview of some commonly used screening instruments for children and adolescents, take a look at the following resource. These instruments screen for a variety of issues, from behavioral and psycho-social disorders to substance abuse problems. Please note that this list is not exhaustive, nor does the TA Partnership endorse any one of these instruments over any others.
Lessons Learned from Established Systems of Care of Children with Serious Emotional Disturbances
Children with serious emotional disturbances can benefit from comprehensive, community-based "systems of care" that coordinate various agencies and programs (and involve families) in offering services. The Research and Training Center for Children's Mental Health has several new briefs examining how and what communities across the country are doing -- and what works.
Assessing the Mental Health of Adolescents: A Guide for Out-of-School Time Program Practitioners (PDF)
Trauma Resources
Helping Youth Overcome Abduction Trauma
The Office of Juvenile Justice and Delinquency Prevention (OJJDP) has published "You're Not Alone: The Journey From Abduction to Empowerment." Written by five survivors of child abductions, the publication provides information to help child abduction survivors cope with their experiences and begin the journey toward a better future. It joins two previous OJJDP publications, "When Your Child Is Missing: A Family Survival Guide" and "What About Me? Coping With the Abduction of a Brother or Sister," in a series that assists families coping with abduction.
From the National Child Traumatic Stress Network
The best resource for information and materials on trauma and children is the National Child Traumatic Stress Network (NCTSN). All of the following resources have been developed by the NCTSN and can be found at this Web site.
- Understanding Child Traumatic Stress
Before we discuss what is meant by a traumatic experience or traumatic stress, let's think about how we recognize and deal with danger. Dangers can become traumatic when they threaten serious injury or death.
They also have additional resources for Parents and Caregivers and Educators.
Helping Families and Children Cope With Traumatic Events
Kids of all ages are talking about the VA Tech tragedy, says the National Association of Child Care Resource and Referral Agencies (NACCRRA). NACCRRA offers resources to help parents, child care providers, school staff and others talk with kids, help with healing, and calm their fears.
Resources to Help in the Aftermath
The American Academy of Pediatrics has posted a list of resources for parents, teachers, students, schools, and pediatricians.
Talking to Kids About School Violence
From the NYU Child Study Center, numerous resources to help parents, teachers, child care workers, and others support kids and teens.
SafeYouth.org
Part of the National Youth Violence Prevention Resource Center, this site provides information on school violence, including fact sheets for teens and a guide for safe schools.
From the Connect for Kids Archives: Help with the Healing, on the Web
Created after high-profile school shootings and the 9/11 attacks, these resources help children and adults deal with trauma.
Media Resources
For reporters and others, the Casey Journalism Center on Children and Families has a source list of experts on school violence, mental health, and trauma.
YPAC Resources
How has the Virginia Tech tragedy affected you, and what do you think is important for your elected officials and media to know about it? How should they respond? The Youth Policy Action Center is giving youth and adults a forum to share their views, and resources to donate to the Cook Counseling Center at the school.
The Child Well-Being Index
The newest Foundation for Child Development study says that after years of improvements in health, safety, and well-being, we're at a "standstill." The good news: continued improvements in teen pregnancy, violent crime, and youth drug and alcohol use are pushing safety ratings upward. But children's health is declining dramatically. The tiny improvements and declines in other areas lead to an overall standstill. (Online you'll find video, audio and materials from the April 17 release.)
This year's UNICEF Child Well-Being Study ranked the U.S. near the very bottom among rich nations in ensuring children's health, safety, and emotional well-being. (See OneWorld US article by CFK's Caitlin Johnson.)
DoSomething.org Chat Boards and Grants
DoSomething.org has an open chat board for young people to discuss the tragedy, and also compiles grant listings, including many to help adults and youth create safer schools.
- GameStop Youth Grants
DoSomething.org is offering grants of $500 to get community projects going. Here's what the organization says: "With a little moolah, some attention from the media and great resources from us, 25-and-unders across the US and Canada can make things happen in a huge way!" There is no deadline to apply.
Attention Deficit Hyperactivity Disorder (ADHD) Resources
There are many misconceptions about ADHD. The following web resources will help clarify some of those misconceptions and offer information about prevalence, causes and treatment.
Attention Deficit Hyperactivity Disorder (ADHD) is a condition that becomes apparent in some children in the preschool and early school years. It is hard for these children to control their behavior and/or pay attention. It is estimated that between 3 and 5 percent of children have ADHD, or approximately 2 million children in the United States. This means that in a classroom of 25 to 30 children, it is likely that at least one will have ADHD.
Attention-Deficit/Hyperactivity Disorder: Prevalence, Causes and Treatment
As its name implies, attention-deficit/hyperactivity disorder (ADHD) is characterized by two distinct sets of symptoms: inattention and hyperactivity-impulsivity (see Table 3-3). Although these problems usually occur together, one may be present without the other to qualify for a diagnosis (DSM-IV). Inattention or attention deficit may not become apparent until a child enters the challenging environment of elementary school. Such children then have difficulty paying attention to details and are easily distracted by other events that are occurring at the same time; they find it difficult and unpleasant to finish their schoolwork; they put off anything that requires a sustained mental effort; they are prone to make careless mistakes, and are disorganized, losing their school books and assignments; they appear not to listen when spoken to and often fail to follow through on tasks (DSM-IV; Waslick & Greenhill, 1997).
Myths and Misconceptions About ADHD: Science over Cynicism (PDF)
The National Resource Center on ADHD has a useful article on the myths and misconceptions and misinformation about ADHD. More information is available at http://www.help4adhd.org/en/about/myths.
Fact Sheet: Current Research on ADHD
The Attention Deficit Disorder Association has created a factsheet with current research on ADHD, including information about who has it, and how to treat it.
Co-existing Conditions
Individuals with ADHD sometimes have other conditions at the same time, including:
These are referred to as coexisting, co-occurring, or comorbid conditions. A full list can be found here at http://www.help4adhd.org/en/treatment/coexisting/WWK5. It is important that coexisting conditions are considered in the evaluation and treatment of ADHD. There are more links to information available at http://www.help4adhd.org/en/treatment/coexisting.
Bipolar Disorder
Bipolar Disorders vs. ADHD
This article from ADDitude Magazine Online outlines the differences between bipolar disorders and ADHD.
About Pediatric Bipolar Disorder
The Child and Adolescent Bipolar Foundation (CABF) has a wealth of information describing the differences in symptoms of bipolar disorders found in children versus adolescents. This article includes practical information on the different types of bipolar disorders, treatment, side effects of treatments, diagnosis in youth, the relationship between substance abuse and bipolar disorders, covers the question of genetics and bipolar disorders. Also included are prominent people in history who have shown signs of Bipolar illness as well as useful information for parents on how they can help their child and how to find a doctor.
The Bipolar Child Web Site
This Web site offers advice on how to start a support group for parents of children with bipolar disorders.
Substance Abuse Resources
Guides for Out-of-School Time Program Practioners
Two guides are available from Child Trends that are designed to assist those running before- and after-school programs for youth in the assessment of mental health and substance use and abuse:
Using Outcomes to Assess Teen Substance-Use Treatment Programs – How Feasible
Some 150,000 people under the age of 18 enter substance abuse treatment programs each year—but there is scant information about which approaches work best. Federal and state agencies are looking into whether outcome data is useful in assessing treatment programs, but the researchers of this study say a more promising approach may be to identify quality-of-care indicators to assess performance.
Girls and Drugs (PDF)
This report from the National Youth Anti-Drug Media Campaign provides and analysis of the recent trends, risk factors, and consequences of drug use among adolescent females.
The RWJF Reclaiming Futures Initiative: Improving Substance Abuse Interventions for Justice-Involved Youths (Abstract only)
This article in the Juvenile and Family Court Journal looks at early evidence of the initiative and finds it is improving the quality and delivery of substance abuse services for justice-involved youth.
Development of a Screening Tool to Identify Adolescents Engaged in Multiple Problem Behaviors: The Adolescent Risk Behavior Screen (ARBS) (Abstract only)
The purpose of this resource is to describe the development of a new, brief screening tool to identify teenagers engaged in multiple, co-occurring high-risk behaviors, and to create a screen that bypasses problems associated with assessment of sensitive and potentially stigmatizing behaviors by including questions that are minimally threatening and less transparent than purely face valid items.
Additional Resources
Suicide Trends Among Youths and Young Adults Aged 10-24 Years, United States, 1990-2004
In 2004, suicide was the third leading cause of death among youth and young adults aged 10-24 years in the United States, accounting for 4,599 deaths. To characterize U.S. trends in suicide among persons aged 10-24 years, the Center for Disease Control and Prevention analyzed data recorded between 1990 and 2004, the most recent data available. Results of that analysis indicated that, from 2003 to 2004, suicide rates for three sex-age groups (i.e., females aged 10-14 years and 15-19 years and males aged 15-19 years) increased significantly, departing from otherwise declining trends.
The National Alliance on Mental Illness (NAMI)
This section of the NAMI Web site has brief but useful facts on bipolar disorders in children and adolescence, including prevalence, symptoms, treatment, side effects of treatment, and more.
Child Mania Rating Scale
The Depression and Bipolar Support Alliance's Child Mania Rating Scale (CMRS) is designed for parents to use as a screening instrument for mania.
Suicide: Adolescents and Young Adults (PDF)
Frequently Asked Questions
Question: Is there a link between marijuana and mental illness?
Answer: The simple answer is yes. Recent research has found a strong case that marijuana smoking, not only is related to the development of mental illness later in adolescence and early adulthood, but that there may be a causal link between marijuana use and the development of psychiatric symptoms, especially schizophrenia. Marijuana is more potent now and adolescents are using it at alarmingly earlier ages. It is used far more than any other illicit drug. The association between when marijuana is first smoked and the later development of mental health problems is strong. Read the full response here.
Question: What is the prevalence of suicide among youth and what roles do risk and protective factors play?
Answer: Suicide is the third most prevalent cause of death in this country for youth ages 10–24. Eleven percent of deaths of children, youth, and young adults within this age group are due to suicide. More females attempt suicide, but more males complete it (78-90% of attempts by males are completed) (1,2). The largest body of data comes from the 2005 Youth Risk Behavior Survey (YRBS) (3), a survey conducted by the Centers for Disease Control and Prevention (CDC). The 2005 YRBS includes data trends between 1991-2005 in selected risk behaviors. Data are collected from 40 states and 21 local surveys. Read the full response here.
Question: How do I know if my child has a depression disorder, or if it’s just the blues?
Answer: It can be very difficult for parents to gauge whether their child has a depression disorder (or even more than one), or simply “has the blues” or is going through a phase, but it’s increasingly important to be aware of the symptoms of depression disorders. In the United States, at least 1 percent of preschoolers, 2 percent of prepubescent children and 5 to 8 percent of adolescents are known to suffer from depression, and research suggests the frequency of depression disorders are increasing with each generation. The number of children with depression may actually be considerably higher because not all children with disorders are diagnosed. In fact, studies have found that only one-third of parents who suspect that their child might have psychosocial problems discuss their concern with the child’s physician. Read the full response here.
Question: What is Autism and is it on the rise?
What are recommended screening and diagnostic tools for Autism and other Autism Spectrum Disorders (ASDs)?
Answer: Autism or Autistic Disorder is one of five Autism Spectrum Disorders (ASD). It is also the most common. Two other disorders have similar symptoms. They are Pervasive Developmental Disorder-not otherwise specified (PDD-NOS) and Asperger Syndrome. The three differ in terms of when the symptoms start, how fast they appear, how severe they are, and their exact nature. The other two ASDs are Rett Syndrome and Childhood Disintegrative Disorder. Read the full response here.
[top]
Policy Issues
Recommendations for State Policies that Support Healthy Growth and Development in Early Child Care Settings (PDF)
Charting Progress for Babies in Child Care: Policy Framework Summary sets forth four key principles that establish the foundation of supports that all infants and young children in child care need, as well as 15 recommendations that State child care licensing, quality, and subsidy policies should address. The summary was developed by the Center for Law and Social Policy (CLASP) and the Zero to Three Policy Center during the first year of a multi-year effort to identify State policies that support the healthy development of infants and young children in child care settings and to build an online resource to help States implement these policies. Future products will include research-based rationales supporting each recommendation and a new section on the CLASP Web site that presents the full framework with sets of policies that may help States move toward each recommendation.
Sex Education Before Age 15 Discourages Teens From Becoming Sexually Active, Study Finds
A new study from the Journal of Adolescent Health shows that both boys and girls who receive some form of sexual education before age 15 are less likely to have sex before age 15. Boys who receive sexual education are also more likely to use contraception the first time they have sex.
National Mentoring Month
The National Mentoring Month campaign 2008 is a joint effort of the Harvard Mentoring Project, The National Mentoring Partnership (MENTOR) and the Corporation for National and Community Service. Get the latest on what Congress has done to suppport mentoring, and find out what's going on in your hometown -- or get something started!
Domenici & Kennedy Celebrate Senate Passage of the Mental Health Parity Bill
The Senate passage of the Mental Health Parity Act (S.558) was announced. The new legislation will provide help to more 113 million Americans, and represents a major agreement between the health care community, business leaders, and insurance industry.
Addressing the Needs of Young Children in Child Welfare: Part C—Early Intervention Services
Created by the Child Welfare Information Gateway, this bulletin provides information about the enactment of Part C referral provisions in the Child Abuse Prevention and Treatment Act (CAPTA) and the Individuals with Disabilities Education Improvement Act of 2004 (IDEA). It also provides examples of State implementation of the new referral provisions, and gives strategies to address potential barriers.
Health Policy News
Preliminary Thoughts on Restructuring Medicaid to Promote Adolescent Health (PDF)
Adolescents are an underserved population in Medicaid. Research shows that their early periodic screening, diagnosis, and treatment (EPSDT) screening rates are low and States' preventive care requirements for them are weak. Additionally, payment policies discourage preventive counseling and the delivery of integrated physical and behavioral care in primary care sites. This issue brief proposes an enhanced set of health promotion and primary care benefits designed specifically for adolescents that can be offered through EPSDT or as an alternative benefit package under the Deficit Reduction Act. It also suggests possible changes to payment policies to support comprehensive preventive and primary care service delivery for adolescents.
Poverty in America: By the (New) Numbers
The resources below are designed to help members of the field make use of Census Bureau data to understand poverty in America and it’s impact on mental health:
National Center for Children in Poverty Newsletter
The July 2007 issue of this Newsletter featured topics on childhood trauma, emergency mental health, reducing disparities and early childhood systems.
America's Children: Key National Indicators of Well-Being 2007
Each year, the Forum on Child and Family Statistics examines key indicators of children's well-being, including family and social environment, economic circumstances, health care, physical safety, behavior, and education. In brief this year: a greater share of kids live with at least one working parent, fewer live in "food insecure" households, and fewer high school students are having sex. However, the percentage of kids without access to adequate healthy water and the lack of affordable, safe housing are rising.
Child Safety and Mortality
Race matters when it comes to deaths by injury, and the disparities have not changed in 20 years. Find out more in the latest Centers for Disease Control and Prevention's (CDC) Morbidity and Mortality Weekly Report Summary.
Lifelong Family Connections: Supporting Permanence for Children in Foster Care (PDF)
Based on Kids Count 2007 data, this 2007 essay focuses on the more than 700,000 children who spend time in foster care each year, and what can be done to strengthen the family relationships that these young people need.
Puerto Rico’s Counts Included in 2007 Kids Count
The 2007 Kids Count edition includes data on children living in Puerto Rico for the first time. The National Council of La Raza has a section specific to the estimated 1 million children living in Puerto Rico.
[top]
Positive Youth Development
Positive Youth Development (PYD) is an approach to serving young people that concentrates on strengths, meeting developmental needs, and focusing on opportunities for growth, rather than on risks, negative behaviors, or problems. In addition, the PYD model stresses the need for youth to become involved in their communities in ways that build on young people’s strengths, give them hope for the future and provides them with success experiences. The following resources describe the history and philosophy of PYD and provide useful advice for ways to implement PYD in your community:
-
Reconnecting Youth & Community: A Youth Development Approach
This primer on youth development was prepared by the Family and Youth Services Bureau’s (FYSB) National Clearinghouse on Families & Youth with the goal of helping communities to modify their thinking and practices regarding services for youth. The guide explains the history and principles of the Youth Development Approach and provides convincing evidence for the shift away from traditional problem-focused approach. The guide also offers guidance on ways to implement a youth development model, develop strategies for promoting strengths in youth, and measure outcomes.
-
Where Need Meets Opportunity: Youth Development Programs for Early Teens (PDF)
This article lists and describes various programs and services offered for young teenagers. It describes the principles of positive youth development and explains why programs must build on the strengths of young people and recognize their need for ongoing support and challenging opportunities. The article also discusses the major challenges to implementation, including issues related to participation, access, and funding, effectiveness, and coordination, and provides solutions for overcoming these challenges.
-
The Search Institute’s “40 Developmental Assets”
The site contains the Search Institute’s Developmental Asset framework, a model of 40 building blocks that can bring about positive youth development. The framework was the product of extensive research collected through surveys, focus groups, and informal discussions. The 40 assets are categorized into two groups: external assets and internal assets. External assets are associated with positive experiences youth receive from external sources, including family, school, and community; while internal assets classify characteristics and behaviors that reflect positive internal growth and development.
-
A Guide to Positive Youth Development (PDF)
This Guidebook was developed by the Assets Coming Together (ACT) for Youth initiative. It was designed to help agencies and programs incorporate PYD into their work. The Guidebook begins with an introduction to PYD and to the Search Institute’s 40 developmental assets. It goes on to describe the history and current state of the youth development movement in the U.S. The second section contains a series research-based fact sheets on a variety of topics related to healthy adolescent development. Three appendices provide: additional resources on PYD; assessment tools for program planners; and opportunities for professional training in youth development.
-
Developmental Assets and the Promotion of Positive Development: Findings From Search Institute Data (PDF)
This article comes from the Summer 2005 issue of Focal Point, a semiannual bulletin developed by the Research and Training Center on Family Support and Children's Mental Health. The article describes the PYD approach and summarizes the Search Institute’s research on developmental assets. A noteworthy finding is that youth engagement in after-school activities was the most consistent predictor of positive outcomes for youth of all racial/ethnic backgrounds. Additionally, self-esteem, decision-making and planning skills were strong predictors of positive outcomes for diverse youth. The authors also state that for youth of color, family variables, such as the provision of support and community variables such as the presence of adult mentors, were significant contributors to thriving. The authors focus their discussion on how community assets and individual assets work together to promote thriving behaviors, such as helping others or school success.
Building Hope for Adolescents: The Importance of a Secure Social Base (PDF)
This article also comes from the Summer 2005 issue of Focal Point. The article discusses the role of hope in the lives of young people with emotional and behavioral challenges. The availability of mentors, “coaches,” and/or consistently available and responsive caregivers are critical in developing hope. According to the authors, building and maintaining hope can help with resilience and recovery, which is particularly important for adolescents’ transition to adulthood. The article also discusses interventions that can help to increase hopefulness.
Frequently Asked Questions
Question: What is Positive Youth Development, and how can I incorporate it into my system of care?
Answer: Positive Youth Development (PYD) is an approach to serving young people that concentrates on strengths, meeting developmental needs, and focusing on opportunities for growth, rather than on risks, negative behaviors, or problems. In addition, the PYD model stresses the need for youth to become involved in their communities in ways that build on young people’s strengths, give them hope for the future and provides them with success experiences. Read the full response here.
[top]
Other
Frequently Asked Questions
Question: What is the role of the Clinical Director in a system of care?
Answer: As you may have heard, a system of care is not a “project” nor is it even a “grant.” It is a systems transformation process, not a “tweaking” of the current system. It is also a cooperative agreement between you and SAMHSA in which there are certain expectations made of both parties. So too, it is not business as usual in service delivery. In fact, the service delivery model of a system of care should look very different from the traditional clinic/office based model. The role of the clinician him/herself is also different. Not only is the clinical director a clinician, but in a system of care he/she is an administrator, manager, community convener, consensus builder, infrastructure builder, supervisor, teacher, mentor, collaborator, decision-maker, treatment/practice expert and leader. Read the full response here.
Question: What is the difference between a screening instrument and an assessment instrument?
Answer: What is the difference between a screening instrument and an assessment instrument? This is often a confusing issue, although it is not necessarily asked frequently because people assume to know the answer. There is no absolute clarity about the difference between the two processes because the distinction depends on who you ask and what instrument you are referring to, as some instruments are not clearly one or the other. Read the full response here.
[top]
