Adolescent and Young Adult Behavioral Health Blog
the #ScreenToInterveneForAYAs Adolescent and Young Adult Behavioral Health
Blog! Supported by the Adolescent and Young Adult Health National Resource Center,* this is a space for state Title V maternal
and child health professionals and their partners to learn about efforts to
build better preventive care systems for optimal adolescent and young adult
wellbeing across the country. As you navigate this site, you’ll see short posts
that include food for thought, resources, reflections, and stories related to
the work being done by Title V to support optimal emotional wellness among
AYAs. Please feel free to share your reactions, ideas, and feelings
by tweeting us (@AMCHP_GrowingUp) and using the hashtag,
To receive updates whenever a new post is published, sign up here: http://bit.ly/2Fzr2JD
like to submit a post, please contact Anna Corona (firstname.lastname@example.org) to have
your writing featured!
Anna Corona |0||6/24/2020 8:26 AM|
In honor of Pride Month (learn the history of Pride Month), we asked State Maternal & Child Health (MCH) programs to share
what they are doing to improve and support emotional well-being among lesbian,
gay, bisexual, transgender, queer and questioning (LGBTQ) youth in their
states. We know that LGBTQ youth experience life differently than their
cisgender, heterosexual counterparts, including increased likelihood of
experiencing negative mental health outcomes as evidenced by the results of the
Project’s National Survey on LGBTQ Youth Mental Health. Two key points from
the survey: LGBTQ youth are more likely to consider attempting suicide and they
report feeling sad or hopeless for at least two weeks in the past year.
State MCH Programs are working on supporting and improving
LGBTQ youth mental health in their settings. Here’s a snapshot of what they are
Assessing for LGBTQ-Friendliness: The Tennessee MCH program partners with their state's Title X Family Planning Program to implement an annual teen, male, LGBTQ friendliness assessment in family planning clinics across the state. The survey allows clinics to assess themselves and illuminate areas where they can improve male, teen, and LGBTQ-friendliness within their practice. To address the assessed areas of improvement, the TN MCH program will partner with local, youth-led reproductive justice and LGBTQ organization to advise on innovative solutions. If you are interested in viewing the assessment, click here.
Partnering to Provide Trainings:
The Florida Maternal, Child & Adolescent Health (MCAH) Program partners with Equality Florida, an organization dedicated to securing full equality for Florida’s LGBTQ community, to offer trainings to school district staff and health education. The trainings include sexual minority competency and creation of safe spaces. In addition to partnering for trainings, the Florida MCAH Program distributes Equality Florida’s resource to all their youth-serving organizations. The New Jersey Child and Adolescent Health (CAH) Program partners with the Transgender Training Institute to provide trainings for staff of youth-serving programs and services to assist them with ensuring that their spaces are inclusive for transgender and non-binary youth. Policies and practices that are encouraged during the training include providing gender neutral restrooms, using gender affirming pronouns on signatures and name badges, sensitivity training for all program staff, and building inclusivity into all lesson plans, if applicable. Additionally, the NJ CAH Program has partnered with the Department of Children and Families Safe Space Program in their state to provide training and support to foster parents across the state so that they are able to provide a more supportive environment for their foster children who are LGBTQ identified.
Funding Direct Services for LGBTQ Youth: The
Pennsylvania MCH Program has recently released a request for applications to
provide LGBTQ youth behavioral health services. From the RFA, “applicants
will achieve these changes in targeted behavior through the implementation of
evidence-based or evidence-informed behavioral health programming focused on
improving the mental health, reducing substance use, or providing suicide
prevention education for LGBTQ youth ages 12-21 in Pennsylvania.” Stay
tuned for an update on the selected grantees via this blog, coming in the Fall!
Here are additional resources for State MCH Programs and
their partners from The
Trevor Project, the leading national organization providing
crisis intervention and suicide prevention services to LGBTQ people under 25:
|6/24/2020 8:26 AM||No|
Anna Corona |0||6/3/2020 8:57 AM|
It was never a question of if COVID-19 would impact
the emotional well-being of adolescents and young adults (AYAs), but rather, what
will be the extent of the impact? The United States Census Bureau has been
collecting data since April 23, 2020 to shed light on the answer to that
question. The Household Pulse Survey is
distributed weekly with responses analyzed and reported at the same frequency. The
U.S. Census Bureau plans to continue distributing the weekly survey for a total
of 90 days. It includes questions related to employment, education, food
security, health, and housing. The section assessing health impacts includes four questions asking specifically about symptoms of anxiety and depression. The questions are
derived from depression (PHQ-2) and
screening tools and are as follows:
Over the last 7 days, how often have you been
bothered by the following problems…
Feeling nervous, anxious, or on edge?
Not being able to stop or control worrying?
Having little interest or pleasure in doing
Feeling down, depressed, or hopeless?
The results of
the latest weekly survey (distributed May 21-26) found that young adults
aged 18-29 are experiencing the greatest impacts on their emotional well-being based
on reported symptoms of anxiety and depression.
Data summaries prepared by the Centers for Disease Control and
Prevention (CDC) revealed that 29.4% of all respondents reported symptoms of
anxiety and 24.9% of respondents reported symptoms of depression. However, when the data is broken down by age,
those rates are highest among young adults with 39.1% of 18-29 year olds reporting
symptoms of anxiety and 36.7% reporting symptoms of depression.
Data for reported frequency of symptoms of anxiety and depression
during the last 7 days are also broken down by state and are available for
viewing on the
Center for Disease Control’s Household Pulse Survey website. According to
the data, all adult respondents (ages 18+) in Louisiana (41.4%), Nevada (40.7%),
and Florida (39.1%) are faring the worst while Minnesota (26.1%), Iowa (25.9%),
and Idaho (24.8%) have the lowest rates of reported symptoms of anxiety and
After asking “what is the impact?” the next logical question
is, “what can we do about it?” To answer this question, we can look to
localized, youth-led initiatives that are working hard to create community and
connection during a time of physical distancing and social isolation. Groups
like WE RISE and Active Minds are leaning on young adults to reach out to their
peers and share messaging that is supportive to mental health and points to
is a project of the Los Angeles County Department of Mental Health that
organizes “events [that] are calls to action to break through barriers and
defy old assumptions about mental health and the many related social conditions
that compound problems and hurt our communities.” Most recently, this group
hosted a Virtual May that emphasized well-being
through art and opportunities for online connection.
self describes as “the nation’s premier nonprofit organization supporting
mental health awareness and education for young adults.” Headquartered in
Washington, D.C., this organization has a presence at more than 800 colleges,
which includes 550 student-led chapters with “programs and services to
empower student to reduce stigma surrounding mental health, create communities
of support, and ultimately save lives.” Check out Active Mind’s list of
chapters to find one you can connect with in your efforts to disseminate mental
health messaging in your state.
While we’ve highlighted only two organizations, there are
many more organizations just like them across the country—consider finding and
connecting with these types of youth-led organizations in your state to learn
how you can help amplify their messages and support their efforts. The
Adolescent and Young Adult Health National Resource Center recently released a
Young Adult Health: State & Local Strategies for Success” that provides
concrete strategies that Title V agencies and others can use to advance young
For additional support, check out these resources
for taking action to improve the emotional well-being of young adults:
is Louder is a campaign out of the Jed
Foundation that is focused on COVID-specific emotional well-being resources
and messaging for Young Adults.
From the Adolescent and Young Adult National
o Advancing Young Adult Health in
the States—scroll down to view resources under the second banner, labeled
Resources About Adolescents and Young Adults
|6/3/2020 8:57 AM||No|
Anna Corona |0||5/13/2020 1:06 PM|
Many thanks to our guest writer, Sharon Koller, who coordinates the UP for Learning's Getting to 'Y' program, which she highlights below. Although we are experiencing a moment in time that has challenged us to be innovative in the ways we continue engaging youth in our work, we know our readers are pushing forth in their efforts. Please feel free to reach out to the Adolescent and Young Adult National Resource Center (via my email, email@example.com) or directly to Sharon (email below) for assistance with thinking through how the "Getting to 'Y'" youth engagement approach, outlined below, might be adapted for a virtual setting. Happy reading!
" [T]his generation is, and has to be, so concerned with exactly what is happening with our future."
- Alex Smart, high school junior
By: Sharon Koller, Coordinator, Getting to 'Y'
Young people care deeply about the world around them and crave meaningful opportunities to share their insights, wisdom and passion and to improve things now and for the future. Through over a decade of involvement with Getting to 'Y': Youth Bring Meaning to their Youth Risk Behavior Survey (GTY), I have seen such opportunities flourish as adolescents use validated local data to set priorities, engage peers and adults in dialogue about what matters to them, and take action to improve youth health and well-being.
Getting to 'Y' began in 2008 as a partnership between the non-profit organization UP for Learning and the Vermont Agency of Education. The Vermont Department of Health (VDH) became a primary GTY partner in 2013 and continues to see GTY as an important tool in elevating youth voice and connection as part of Maternal and Child Health Title V and Alcohol and Drug Abuse Division prevention work. Dr. Breena Holmes, MCH Director for Vermont, says, "GTY is the strength-based approach to youth voice and agency that public health needs. It is the foundation of our prevention efforts and changes the conversation in communities in meaningful ways." To date, 147 teams from 80 Vermont schools (45%) have participated in GTY, as have 8 teams in 4 public schools in New Mexico.
GTY uses a positive youth development and action-research model where students utilize existing data (local Youth Risk Behavior Survey surveillance data) to take the lead in making sense of their own health information. The process is simple, but effective: (1) a core youth team and their adult advisor attend a youth-led training to learn and practice tools and skills to implement GTY, (2) the core team recruits a larger representative group of peers and leads them through asset-mapping, data analysis, root cause review and initial solution brainstorming, (3) the core team shares their work and leads community dialogue about their findings and ideas, (4) the core team plans and implements actions based on all they have learned throughout the process.
Before becoming the GTY Coordinator at UP for Learning, I advised GTY teams for 9 years at the high school where I worked as a Student Assistance Program counselor. Over and over, I saw the profound impact of GTY on individual and systemic levels. As expected, there were concrete changes that came about as a direct result of the students' work: more accessible condom distribution, a peer-mentoring program, student-led consent training in health classes, and distracted driving education campaigns. Other changes were spurred by school staff and community members hearing the passionate voices of youth at community dialogues. Our school implemented suicide prevention programs in all health classes after the GTY group repeatedly focused on the data around suicide as a top concern.
Even more powerful for me to witness was the impact on individuals. Because GTY addresses issues personally relevant to all youth, and because all youth are experts in their own lived experience, our group drew in students who had leadership roles in the school as well as many students who had never joined a club or led a group of peers and adults. Because the initiative utilizes a strengths-based and structured approach which builds on scaffolded skills and experiences, the diverse groups worked well together and individuals discovered or grew their sense of themselves as capable agents of change. I never tired of hearing the confident voice of a previously "invisible" student leading a group of peers, administrators, parents, community members, and even legislators through a discussion of a sensitive and important health topic.
My anecdotal observations have been upheld by data as well. During the 2018-2019 GTY year, UP for Learning worked with the University of New Mexico Prevention Research Center, with support from VDH, to complete a mixed-methods evaluation of GTY's impact on participants. Pre- and post-survey data of core team and data analysis participants showed significant positive changes in Health Literacy, Self-Efficacy, Community Engagement, Resilience and Protective Factors, and Knowledge, and focus groups. Written feedback pointed to increases in a Sense of Connection, Knowledge and Self-Confidence. Youth noted things like:
"I gained knowledge that I can use to help others around me if they are having a hard time."
"I gained information about the problems and strengths about my community and state."
"I gained a more confident voice and I learned to speak up about my opinion."
"I had more of an opportunity to lead others in the right direction when solving youth risk problems."
"I gotta stay involved 'cause this is the way to help the community."
"I gained friendship and I've learned that I can trust people, and I don't really trust people much. Before this I only trusted 3 people. Now I trust like 10 people."
Getting to 'Y' is well-poised for replication by other states interested in engaging youth in meaningful work around their own health and well-being. UP for Learning is excited to envision a time when youth across the nation are seen as integral partners in utilizing the YRBS as a springboard for change. Who better than youth to bring meaning to their own health data and then experience the satisfaction of making the world a better place?
Information available on the GTY website or from Sharon Koller: firstname.lastname@example.org
|5/13/2020 1:06 PM||No|
Anna Corona |0||4/22/2020 11:10 AM|
By: Lyndsey Reece, DHAChild and Teen Checkups Coordinator, Rice County Public Health (Minnesota)
Minnesota Adolescent and Young Adult Behavioral Health (AYA BH) CoIIN Team has
prioritized youth engagement as a part of their work to improve the rates of
depression screenings among AYAs ages 12-24 in their state. One of the team’s
most recent youth engagement endeavors centers around partnership with a
youth-led group called “Moving In New DirectionS
(M.I.N.D.S.)”. M.I.N.D.S. is a team of 12
high-school aged youth from four schools in Rice County, MN that were recruited
through a partnership between public health and a school counselor. M.I.N.D.S.
aims to partner with the MN CoIIN team on tackling the following goals: 1) educating adolescent and young adults that
they have a voice and how to use it, 2) shining a light on mental health to break
stigma, and 3) communicate with the community on how to support adolescents and
order of business for the group was to brand themselves and hammer out an
action plan for how they wanted to achieve their goals. The M.I.N.D.S. team
came up with their group name, a logo, and a work plan to shine the light
on AYA mental health in Rice County. For the group, “shining a light on mental
health” means to reducing stigma and showing that it is normal to face mental
health concerns. The youth believe that raising awareness of mental health will
help knock down barriers to accessing mental health supports that they see
throughout the community.
their agenda, M.I.N.D.S. plans to survey adolescent and young adult students
from their four high schools on several
questions regarding their perceptions of and personal experience with mental
health as well as their personal experiences with mental health screenings in community
clinic setting. The M.I.N.D.S. team is also are looking to receive training on
advocacy skills for taking charge of their health during primary care visits. The
M.I.N.D.S. youth are also planning a mental wellness event within the community
for their peers in all schools as a way to support their goal to break the
stigma associated with mental health challenges.
momentum up during the current social distancing brought on by COVID-19, Rice
County public health and the M.I.N.D.S team are planning to continue their work
by utilizing Google Classroom as an online platform for organizing and storing
their team documents and communications.
In lieu of in-person meetings, the group is meeting online using Google
Hangouts as regularly as they did pre-social distancing. During each virtual
convening, the public health team kicks of each meeting by checking in with
each of the M.I.N.D.S. team members to ensure they are receiving the resources
they need to maintain their overall well-being during the pandemic. After the
initial check-in, M.I.N.D.S. members take the reigns of the conversation and
strategize on how best to keep this important work moving forward. During their
last meeting, the M.I.N.D.S. team decided their immediate next step will be to
invite relevant community organizations to join their virtual meetings as a way
to begin partnership building in preparation for a time when it will be
possible to gather again in-person. The M.I.N.D.S. youth also expressed
interest in connecting with their school and clinical leadership to provide
expertise on how adults can be supportive to youth during this time. Although
the pandemic has created unprecedented barriers for community organizing, the Minnesota
AYA-BH CoIIN team and their M.I.N.D.S. partners are finding ways to make progress
despite the challenges.
|4/22/2020 11:10 AM||No|
Anna Corona |0||4/8/2020 1:55 PM|
Combatting Stigma in Schools
In South Carolina, the Adolescent and Young Adult Behavioral
Health (AYA BH) CoIIN team has been focused on leveraging existing initiatives to
increase depression screenings with appropriate follow up care for AYAs. To achieve this, the SC team has
strategically infused the MCH perspective within existing
initiatives to share their work and expertise, including the Ending the Silence campaign
being implemented by the National Alliance
on Mental Illness (NAMI) in South Carolina. At a
recent SC CoIIN team meeting, Paige Selking with NAMI SC joined us to share the
work their team is doing to implement the Ending the Silence
program in schools
and communities across the state.
to NAMI’s website, the Ending the Silence program “teaches the next generation
about mental illness through an educational package designed to teach students
on three grade levels: upper elementary, middle school, and high school about
serious mental illness. This easy to use package uses stories to humanize
serious mental illness and teach that these illnesses are no-fault brain
disorders. Students also examine the role the media plays in perpetuating
to direct education to youth, there are trainings for their supportive adults,
such as parents and school staff, to address the same topics addressed in the student
trainings. Perhaps most important is
that someone with a lived experience related to mental illness is always part
of the training. In an effort to bring
more youth into the planning and connecting being done by the SC CoIIN, it
became important to the group that we support the NAMI efforts to include the
lived experiences of youth in their presentations and have made those
connections wherever possible. For
example, the CoIIN team has connected NAMI with the Statewide Child
Well Being Coalition, and they will be bringing the Ending the Silence training to this
body once large gatherings can be held again.
Additionally, NAMI will be presenting to the State Alliance for Adolescent Sexual Health and the training
will include insight from a young person living with mental/behavioral health
issues. Both of these bodies include professionals and community leaders who
work directly with adolescents and young adults.
Check out NAMI’s national webpage to find your state’s local NAMI chapter.
Amidst a Global Pandemic
the limitations that have been placed on many organizations as a result of the
CoVID-19 pandemic, the needs of organizations that reach out to youth have
changed. To adapt to our changing
environment, the CoIIN team is working is shifting the ways in which we support
these organizations, including publicizing and featuring NAMI’s online trainings
that have been organized since the start of quarantines across the state. Work
to identify and include organizations that represent youth through youth voices
has also been an increased focus during this time. Gender Benders, an organization working to ensure that the
LGBTQ community, especially transgender individuals, has access to safe spaces,
resources, and support, is one organization that has not yet been represented
in the SC CoIIN work, but has accepted
an invitation to join the efforts at our April meeting. Gender Benders has a strong youth leadership
component that will center important voices into the conversation related to
supporting the emotional well-being of AYAs across SC.
As the work
in SC continues to progress in ways we had not originally planned due to
COVID-19, we are taking this opportunity to think and collaborate outside the
box to determine where the needs of AYAs in SC are the most immediate. Our hope is that the voices of youth will
guide our collaborations and outreach more and more as we are pushed further
into areas where we have not historically thought to go.
By: Rebecca Williams-Agee, MSW, MPA
PREP/Adolescent Health Coordinator, South Carolina Dept. of Health
and Environmental Control
|4/8/2020 1:55 PM||No|
Anna Corona |0||3/24/2020 2:30 PM|
Hello, and welcome to the fifth and final installment in our "Approaches to Measuring Quality Improvement in Public Health" series! While quality improvement principles have traditionally been implemented in clinical settings, this series is focused on unpacking a measurement framework to apply a Q.I model/lens to public health, systems-level work. In our most recent post, we focused on the Assessment, Measurement, and Monitoring piece of the framework. The post highlighted the Vermont Adolescent and Young Adult Behavioral Health (AYA BH) CoIIN team's efforts to take inventory of current related efforts across the states and to prioritize AYA BH needs by incorporating several relevant measures within their state Title V action plan.
For today's entry, we'll be zooming in on the Partnership piece of the QI framework. This domain emphasizes the importance of developing new and/or enhancing existing relationships within state government and external entities as well as the value of coordinating efforts between partners. Read on to learn how Indiana's AYA BH CoIIN has operationalized this tenant of the framework.
Centering around Provider Capacity-Building: An Example of State-Level Partnerships in Indiana
By: Steven Holland, Bureau Chief, Youth Services, Division of Mental Health and Addiction
In practice, many systems struggle with meaningful connections to other relevant partners. Often, the situation occurs where the right hand is not aware of what the left hand is doing. The Indiana AYA BH CoIIN team has a history of forming and maintaining key partnerships that goes back to their participation in the first iteration of this CoIIN project, which focused more generally on the uptake and quality of the Adolescent Well-Visit. For the current iteration of the CoIIN project, which has a more specific focus on depression screenings within the well-visit, the team includes members from the State Department of Health, Division of Mental Health and Addiction, Medicaid/Anthem insurance, Indiana University, and Foster Success (a local agency that provides services to foster youth). In addition to the public health team partnerships, the Indiana team successfully recruited clinical partners around the state hungry for information about how to improve rates of depression screening with a follow up care plan for adolescents and young adults, ages 12 to 25. In all, 21 practices, primarily of Family Medicine, were recruited with 29 health care professionals participating to learn more about depression screening, evaluation, and treatment.
In an effort to support provider capacity to provide depression screenings for AYAs in their care, the Indiana CoIIN team has centered their current partnership around the development of a state mental health system webinar, which will educate clinical partners on the state resources that are available for behavioral health referrals and consultations. In planning for the content of this webinar, it has become increasingly apparent how valuable the various perspectives of the team members are. While each member has a piece of understanding on how the mental healthcare larger system works, they have only been able to fully address gaps and articulate a more comprehensive picture of the mental health care system in Indiana through incorporation of every team member's knowledge. With the work being done on this webinar, each member of the team will walk away with a more comprehensive understanding of the state mental health system. This will not only create a more cohesive story and understanding of the mental health system among all CoIIN team members and participating clinicians, but it will also facilitate the sharing of information with team member's respective agencies to inform future partnerships and decision-making.
Looking beyond the current project, continued development of the partnerships that make up the Indiana CoIIN has the ability to leave a lasting impact on Indiana's youth and young adults as a whole. As our team works collectively to build support for the medical providers in the field, it is the Indiana CoIIN team's hope that adolescents and young adults will be able to access behavioral health care more efficiently and effectively.
|3/24/2020 2:30 PM||No|
Anna Corona |0||2/26/2020 9:56 AM|
Hello, and welcome to the fourth installment in our "Approaches to Measuring Quality Improvement in Public Health" series! While quality improvement principles have traditionally been implemented in clinical settings, this series is focused on unpacking a measurement framework to apply a Q.I model/ lens to public health, systems-level work. In our most recent post, we focused on the Augmenting MCH Capacity piece of the framework. The post highlighted the Wisconsin Adolescent and Young Adult Behavioral Health (AYA BH) CoIIN team's efforts to support improved primary care provider's capacity for caring for their patient's emotional well-being through promotion the state's child psychiatry consultation program.
For today's entry, we'll be honing in on the Assessment, Measurement, and Monitoring piece of the QI framework. This domain emphasizes the importance of assessing the current landscape of efforts across the state focused on AYA emotional well-being as well as creating a defined measurement plan to inform intervention and monitor outcomes. Read on to learn how Vermont's AYA BH CoIIN has operationalized this tenant of the framework.
Assessment, Measurement, and Monitoring of Adolescent and Young Adult Emotional Well-Being in Vermont
By: Sally Kerschner, RN, MSN--Coordinator of MCH Injury Prevention, Vermont Department of Health
Vermont has spent much of its initial CoIIN efforts in the assessing the current landscape of existing mental health integration efforts across the state. In creating this inventory, the team realized that several projects and programs have been intentionally developed over recent years by many partners, all with a goal of achieving comprehensive and best practice screening processes in a variety of practice settings.
Below is a partial list of key projects or initiatives in Vermont:
This assessment of existing efforts and the resulting inventory has illuminated the need to partner with, or at the very least, coordinate with these varying programs in order to avoid duplication of efforts. It is important to be intentional in avoiding duplication to avoid creating skepticism among front-line practitioners and inefficiencies in implementation. Moving forward, a key strategy is to assist our Department of Health and Department of Mental Health state agency leaders in coordinating these various efforts by developing better routine communications channels to be aware of the progress of each initiative.
Measurement and Monitoring
Vermont's CoIIN is working to augment and complement several other programs and initiatives to address upstream youth mental health and wellness, including suicide prevention. Vermont does not have dedicated injury or suicide prevention funds, however, we work to integrate public health interventions into our existing capacity. In order to anchor the key public health issue of youth suicide prevention in our work, we incorporated key measures into our MCH Title V Grant planning. The following priority needs are reflected in Vermont's current state action plan and will be revised after the Title V 2020 Needs Assessment process:
Priority: Youth choose healthy behaviors and thrive
State Performance Measure: Percent of adolescents that feel they matter to people in their community
- By 2020, increase awareness among health care providers of the importance of annual preventive health visits for adolescents to 75%.
- By 2020, increase awareness among parents/ caregivers and patients (adolescents) on the importance of preventive health visits for adolescents to 75%
- By 2020, increase access to preventive health visits in medical homes and school-based health centers by 20%
Strategies to Meet Objectives:
- Partner with pediatric primary care practices to increase both access to and quality of well care visits for the adolescent and young adult.
- Provide TA and strategies to school nurses to facilitate connections between schools and medical homes.
- Strengthen partnerships with Vermont's ACOs to leverage opportunities to focus on improving adolescent well-care visits.
Priority: Children live in safe and supported communities
State Performance Measure: Percent of high school students who made a plan to attempt suicide in the past 12 months (measured using the Vermont's Youth Risk Behavior Survey)
Supporting Objective: By 2023, increase the percentage of youth and adults screened for suicidality in the primary care setting by 25%.
Strategies to Meet Objectives:
- In partnership with the Vermont Child Health Improvement Program, collect and report on quality improvement data from pediatric practices on depression screening. MCH Leadership supports the AYA CoIIN for systems improvement in screening youth for depression and other factors that may lead to suicidality.
- Support presence of Umatter Youth and Young Adults Mental Health Wellness Promotion and Community Action in 10 schools statewide.
|2/26/2020 9:56 AM||No|
Anna Corona |0||2/5/2020 3:31 PM|
Hello, and welcome to the third installment in our "Approaches to Measuring Quality Improvement in Public Health" series! While quality improvement principles have traditionally been implemented in clinical settings, this series is focused on unpacking a measurement framework to apply a Q.I model/ lens to public health, systems-level work. In our most recent post, we focused on the leveraging existing initiatives part of the framework, which featured how the South Carolina Adolescent and Young Adult Behavioral (AYA BH) CoIIN team prioritized this domain as a part of their work to align efforts and enhance synergy for improving AYA emotional well-being in their state.
The Augmenting MCH Capacity and Strategies of this QI framework emphasizes increasing and enhancing the capabilities and skillsets of the workforce and sectors that are essential to addressing the emerging issues related to AYA emotional well-being. This can include training MCH staff on understanding the mental health needs and conditions that arise during adolescent years, utilizing strategies to identify and prioritize AYA populations and communities that may experience inequalities that contribute to mental health disparities, or efforts to assist providers in their ability to screen and refer their AYA patients for depression, anxiety, and other conditions accordingly. Read on to learn about the systems in place in Wisconsin to support primary care providers on addressing mental health needs of patients through a statewide psychiatry consultation program.
Supporting Wisconsin Primary Care Providers in Caring for Children, Adolescents and Young Adults with Mental Health Problems: Wisconsin Child Psychiatry Consultation Program
By: Arianna Keil, MD, Quality Improvement Director, Children's Health Alliance of Wisconsin & Wisconsin Department of Health Services' Family Health Section
Wisconsin is pleased to be participating in the public health and primary care arms of the adolescent and young adult (AYA) behavioral health Collaborative Improvement and Innovation Network (CoIIN). Over two thirds of Wisconsin counties do not have a child psychiatrist, so AYAs commonly receive mental health care from primary care providers (PCPs). Many of these PCPs, however, say they did not get enough training to provide the scope of mental health services asked of them. One part of the solution to this complex problem is the Wisconsin Child Psychiatry Consultation Program (CPCP).
The CPCP offers real-time telephone and email support to Wisconsin PCPs who have questions about how to best care for children and AYA with mental health problems. Available in 65 of 72 counties, the CPCP is staffed during normal office hours by child psychiatrists and a pediatric psychologist, as well as mental health professionals knowledgeable about services available in specific communities. The program is administered through Children's Wisconsin and the Medical College of Wisconsin, and funded in part through a grant from the Wisconsin Department of Health Services' Maternal Child Health Program. Wisconsin is part of a national network offering this type of support.
Since launching in 2015, the CPCP has offered over 3,000 consultations and enrolled over 750 providers. Over half of the contacts are by email, and nearly all questions are answered within one day. Depression is the fourth most common presenting issue, behind anxiety, attention deficit hyperactivity disorder (ADHD) and disruptive behavior. Medication questions are by far the most common reason why PCPs contact the program. PCPs are very satisfied with the support they receive: nearly all (97%) indicate that CPCP consultations have helped them more effectively manage patient care, and that information learned will be used in future care of patients.
"The CPCP has been a wonderful resource for me as a primary care provider. The ability to have direct access to psychiatrists has helped me to treat and give resources to children I normally wouldn't have been able to help. The program helps reassure me that my treatment decisions are appropriate and it guides me when complex patients walk in the door that I normally would be uncomfortable treating on my own. Without the program, I would have many patients who would not have access to proper mental health treatment. It truly is a great program!"
WI CPCP also offers educational opportunities to enrolled providers. Topics include:
- Psychopharmacology - includes pharmacologic management of ADHD, depression and anxiety, and atypical antipsychotic agents
- Rating scales and suicidality - includes general screening tools, specific rating scales, and assessment and triage suicidality
- Trauma informed care - includes awareness of the impact of traumatic events, and safe, compassionate and respectful partnering
- Behavioral interventions - includes behavioral dysregulation
- Parents often appreciate and see the benefit of clinician-to-clinician support.
"My son's pediatrician told me of the CPCP services that she was enrolled in and how it worked. She said my son's treatment was outside the scope of her practice but that she could consult with child psychiatrists through this program. I agreed and trusted her. It was a quick turn-around in which my son's pediatrician called me to discuss medication and treatment options. He is currently stable and doing great in school, and he is even excelling in math! I have more respect for my pediatrician for seeking out assistance and using CPCP because we all don't know everything and need help. As the saying goes: It takes a village to raise a child."
Wisconsin providers enrolled in the AYA behavioral health CoIIN will learn about the CPCP on a webinar in March on state-specific resources.
To learn more, visit www.chw.org/CPCP or watch https://www.youtube.com/watch?v=ZTp94VPG2VU&feature=youtu.be
|2/5/2020 3:31 PM||No|
Anna Corona |0||1/22/2020 3:01 PM|
Hello, and welcome to the second post in our "Approaches to Measuring Quality Improvement in Public Health" series! While quality improvement principles have traditionally been implemented in clinical settings, this series is focused on unpacking a measurement framework to apply a Q.I model/ lens to public health, systems-level work. In our most recent post, we introduced the leadership domain of the framework, which featured how the Minnesota Adolescent and Young Adult Behavioral (AYA BH) CoIIN team have laid the foundation for creating a climate that encourages prioritization of AYA emotional wellness in their state.
The leveraging existing initiatives of this QI framework emphasizes the importance of finding and enhancing synergies between active programming to address an issue. More specifically, this domain asks public health teams to consider the following questions: What existing initiatives align well with what my project is trying to achieve? Is my organization invited to the table for these projects? On the flip side, which voices are missing from our own projects and efforts? An important note for this domain: inviting others to your initiative isn't necessarily the priority. Showing up and being willing to pitch in to someone else's initiative can be just as impactful, and still ultimately works toward the overall goal of creating synergy between stakeholders working towards a common aim in order maximize efficient use of resources. Read on to learn how the South Carolina AYA BH CoIIN team prioritized this domain as a part of their work to align efforts for improving AYA emotional well-being in their state.
Leveraging Existing Initiatives in South Carolina
By: Rebecca Williams-Agee, South Carolina's Adolescent Health Program Coordinator
In South Carolina, the AYA Behavioral Health CoIIN team is focusing on leveraging existing initiatives by adding the MCH perspective and capacity. As the team in SC has grown, it has become increasingly apparent that there are numerous initiatives that exist statewide and regionally which focus on optimal emotional well-being for adolescents and young adults. Identifying, connecting and building on the work of these initiatives has become a major emphasis for the SC team, in addition to developing the presence of MCH as a part of them. Identified initiatives include the following:
- The SC Behavioral Health Coalition is a voluntary, multidisciplinary, long-term statewide partnership of both public and private organizations devoted to enhancing and improving access to a comprehensive system of behavioral health care. This diverse group includes a subgroup that specifically prioritizes the emotional well-being of Children and Youth. The Coalition overall is responsible for establishing both short and long-term goals with a primary focus on identifying and disseminating actions based on the needs of individual communities, and this subgroup focuses on those needs specific to children and young adults.
- The SC Suicide Prevention Task Force was created with to strengthen statewide infrastructure that will support improved behavioral health services delivery to potentially suicidal youth and young adults through this task force and regional youth suicide prevention task forces.
- The Child Wellbeing Coalition is a group of local and state agencies, community members and organizations committed to working collectively to mitigate the effects of poverty on children. This Coalition includes multiple workgroups, but the education and health workgroups have chosen to include a focus on behavioral health among youth and young adults.
- Community Crisis Response and Intervention (CCRI) Teams have been developed by the SC Department of Mental Health to provide adults and children access to clinical screening in person at the location of the crisis, at a community mental health center, via phone or telehealth communication software.
- Additionally, multiple inter-agency and intra-agency workgroups and collaborations related specifically to the needs of adolescents and young adults have been identified, including the SC Department of Health and Environmental Control School Aged Youth Workgroup and the SC Telehealth Alliance.
As these initiatives have been identified, CoIIN members have determined that the most effective way to further our objectives is to become actively involved with the existing work rather than beginning a new one with a very similar focus. The AYA CoIIN has been incorporated as a school and community-based workgroup of the larger Children and Youth subgroup of the Behavioral Health Coalition. Members of the CoIIN have become involved in the Suicide Prevention Task force and have plans to incorporate their work into the state-specific information provided to participants in the clinical arm of the CoIIN, as is also the case with the CCRI teams under the Department of Mental Health. The Child Wellbeing Coalition has also included the CoIIN goals in the overall focus of the Health and Education workgroups, in addition to assisting with the identification of funds to support ongoing work of CoIIN ideas and initiatives in local communities.
Specific achievements of the SC CoIIN that have resulted from leveraging existing initiatives include the following:
- In the Behavioral Health Coalition and CWB Coalition, the goals and initiatives of the CoIIN have become the group goals for AYA Behavioral Health focus.
- The CoIIN is working with additional initiatives to combine goals and objectives, specifically those related to school behavioral health response. The results of a survey sent to school nurses across the state related to the behavioral health support available for students within their specific communities are being shared directly with the CoIIN.
Overall, leveraging existing initiatives has become an ongoing focus of the AYA CoIIN in SC, and will continue to guide the work of the group moving forward.
Interested in receiving updates whenever a new post is added to the blog? Sign up here.
|1/22/2020 3:01 PM||No|
Anna Corona |0||1/7/2020 3:30 PM|
We are excited to kick off this series with the first of
five posts in our “Approaches to Measuring Quality Improvement in Public Health”
series. We previously posted an introduction to the framework that state
teams in the AYA Behavioral Health CoIIN are using to measure quality
improvement at the systems level. If you
missed the post, be sure to check it out
before reading any further.
As discussed in the last post, the CoIIN state teams are
using a quality improvement measurement framework that includes five
overarching levers that states can pull in order to advance systems-level
change. The first lever we’re going to
describe is fundamental to any public health effort: leadership buy-in. More specifically, this domain of the
measurement framework challenges state teams to think through the role of their
state’s leadership in implementing strategies to support optimal emotional
well-being for AYAs. Under the
Leadership component, state teams are focused on assessment of things such as: is adolescent and young adult mental health priority at
the state level? Is there funding being allocated to these efforts? Assessing a
state’s baseline in the leadership domain allows the team to prioritize
opportunities to increase leadership buy-in to set the foundation for wider
systems-level changes.. Read on to learn
how the Minnesota CoIIN team was well positioned to take on the work of this
CoIIN through their Minnesota Partnership for Adolescent and Young Adult
Convening Stakeholders to Create a Plan for Adolescent Health in Minnesota
By: Julie Neitzel Carr, Minnesota's Adolescent Health Coordinator
The Minnesota Partnership for Adolescent and Young Adult Health (MN PAH), convened by the MN Department of Health, is made up of multi-sector stakeholders working with and on behalf of young people in the state. This partnership has set the foundation for long-standing commitment by state leadership to advance optimal Adolescent well-being by:
- Collaboratively developing MN's Adolescent Health strategic plan. Each priority area within the plan includes actions steps, community responses, and resources. These priorities help to guide our work to support adolescent and young adults (AYA) health in the state.
- Including "improving the responsiveness of both physical and mental health care for young people in MN" as one of their ten state priorities. In alignment with the Health and Human Services' (HHS) "Five Essentials for Healthy Adolescents," this priority focusing on health care with AYA directly aligns with national projects such as the AYA BH CoIIN focusing on depression screening in primary care settings.
Improving the responsiveness of physical and mental health care for young people supports MN's vision of creating a state where all young people thrive. For more details or questions on MN's work, please contact Julie Neitzel Carr (email@example.com), MN's Adolescent Health Coordinator.
in creating an Adolescent Health strategic plan in your state? Check out the National
Network of State Adolescent Health Coordinators (NNSAHC) resources for developing an
Adolescent Health strategic plan.
|1/7/2020 3:30 PM||No|
Anna Corona |0||12/4/2019 8:59 AM|
Since the onset of the national movement by Title V to combat infant mortality rates using a uniform learning collaborative, state Title V Maternal and Child Health programs have partaken in a number of collaborative improvement and innovation networks (CoIINs) supported by the federal Maternal and Child Health Bureau. Based on the model from the Institute on Healthcare Improvement, CoIINs rely on real-time or reasonably current data and metrics to assess implementation strategies, or "tests of change." Since there is emphasis on rapid-cycle improvement activities, using "good-enough" data is essential, to identify progress and help accelerate solutions to challenges that affect the MCH eco-system. These methods have been typically successful in smaller, clinical, and more controlled settings. But how do these concepts translate when seeking to improve care on a more population-focused aim, and where more time is needed? And how can the MCH workforce and its partners adapt and respond with this approach when it comes to young people's mental health?
With the launch of the Adolescent and Young Adult (AYA)-Behavioral Health CoIIN in 2019, AMCHP was tasked with developing the best way for state public health CoIIN teams to measure their contributions to their unique state aims, as well as the overarching CoIIN Goal: Achieve an 80% screening rate of patients ages 12-25 for a major depressive episode using an age-appropriate standardized tool with documentation of a follow-up plan if the screen is positive. Following the CoIIN motto of "share seamlessly, steal shamelessly," the Adolescent and Young Adult Health-National Resource Center partners examined how other collaboratives measured macro-level improvements, using metric examples from the Infant Mortality CoIIN Social Determinants of Health learning network, as well as measures from the Promoting Innovation in State & Territorial MCH Policymaking (PRISM) initiative. From there, we adapted a measurement framework, originally created by AMCHP's Infant Mortality CoIIN team, Kay Johnson, and Milt Kotelchcuk, to determine where state teams were at baseline, and provide guidance on what levers to pull in order to see some sort of change within their system level opportunities to address depression screening and treatment referrals. We landed on five main pillars:
Each of the five components offers guidance and examples on practice and policies changes that intend to increase the capacity of Title V and its public health and community champions to address mental health screenings and referrals for AYAs. Eager to learn specifically what's involved under each of these measures? The blog will unpack each of these categories in upcoming posts, beginning in January 2020.
|12/4/2019 8:59 AM||No|
Anna Corona |0||11/12/2019 4:12 PM|
the American Public Health Association (APHA) hosted its 2019 Annual
Meeting in Philadelphia, Pennsylvania and I had the wonderful privilege of
attending as both a presenter and an attendee. Of the many interesting sessions,
one in particular stood out as important for me to share with you all, titled, “Workforce
Development: Mental Health Service Delivery by Non-Mental Health Professionals”.
This workshop featured four
presentations that highlighted the potential of thinking “outside the box” when
it comes to the development of the mental health provider workforce. Each of the four presentations, briefly
summarized below, highlighted strategic ways to bolster mental health providers
· Physician Assistants as a crucial
mental health service provider: presented by the National Commission on Certification of Physician Assistants (NCCPA), this talk underscored the
value of including PAs in all mental health service delivery capacity-building
efforts, as their most recent survey of this workforce indicated that approximately
62% of all PAs are evaluating patients
with psychiatric symptoms at least weekly. Check out NCCPA’s website
to learn more about how they are promoting the role of PAs across
disciplines in the management of mental health, mental illness, and substance
· Community health workers (CHWs) as
linkages to mental health care for Latino populations: presented by Kiera Coulter
(University of Arizona), this talk discussed the findings of Coulter’s study,
which explored the association between how a community health worker rates
their clients health (or CHW-rated health) and the client’s depression
symptomology. They found that community
health worker-rated mental health was significantly associated with depressive
symptoms, and often, CHW-rated health was more predictive than client’s
self-rated health. The author described
the immense potential for culturally competent CHWs to serve as linkages to
mental health care for Latino populations given their strong rapport.
· Mental Health First Aid Training as a
tool to reduce stigma:
presented by Jessica Garcia (University of South Florida), this talk pointed to
the effectiveness of the Mental Health First Aid Training as a tool to improve trainees
understanding of mental health, and thus reduce personal stigmas.
· Collaboration between psychiatric and
Primary care residents: presented by Nkema Esiobu (Yale School of Medicine), this talk
highlighted an important mechanism for breaking down silos between primary and
psychiatric care—beginning when providers are still being educated as residents. Esiobu discussed a case study in which
increased collaboration between psychiatric and primary care residents during
their practice-based education could improve primary care provider competency
in managing mental health concerns.
more about each of the presentations, view the abstracts submitted by each
of the authors. Let
us know your thoughts on these approaches to developing the mental and
behavioral health workforce by tweeting us at @AMCHP_GrowingUp!
regularly scheduled post falls on the Thanksgiving holiday, so we’ll be back
early the week of December 2nd with a post-Turkey Day update. Wishing
everyone a safe and happy holiday!
|11/12/2019 4:12 PM||No|
Anna Corona |0||10/30/2019 3:17 PM|
During the 2019 Title V Federal-State Maternal & Child
Health Partnership meeting, our very own Dr. Charles Irwin was awarded the Title V Lifetime Achievement Award
from the Maternal and Child Health Bureau (MCHB). This award recognizes outstanding
contributions made to the field of maternal and child health over a sustained
period. Dr. Irwin earned this award as a
result of his decades of contributions to improving the quality of preventive
care for adolescents and young adults. He has served as the Director of the Adolescent & Young Adult
Health National Resource Center since its inception in 2014 and is a distinguished
professor of pediatrics at the University of California School of Medicine and
the UCSF Benioff Children’s Hospital. Check
out Dr. Irwin’s bio
to learn more about the breadth of his contributions to this field and join us
in congratulating him on this well-deserved recognition!
Stay tuned for our next blog post: AMCHP’s Child
& Adolescent Health Team is headed to the American Public Health
Association’s (APHA) 2019 Annual Conference in Philadelphia, PA and we plan to share
key adolescent and young adult behavioral health takeaways with you. Follow us at @AMCHP_GrowingUp and let us know
if you’ll be attending the APHA Annual Conference as well.
Happy Halloween, Adolescent & Young Adult Health
Dr. Charles Irwin (center) receives MCHB’s Title V
Lifetime Achievement Award and is joined by MCHB’s Associate Administrator, Dr.
Michael Warren (left) and MCHB’s Deputy Associate Administer, Laura Kavanagh
|10/30/2019 3:17 PM||No|
Anna Corona |0||10/15/2019 2:40 PM|
For today's blog post, I'd like to highlight a very exciting pillar of the AYAH National Resource Center's programmatic work: the Adolescent and Young Adult Behavioral Health Collaborative Improvement & Innovation Network. Yes, that's quite a long name; let's lovingly refer to this project as "the CoIIN" for the rest of this post. We at AMCHP, in partnership with the National Improvement Partnership Network (NIPN), are thrilled to have the privilege of administering the CoIIN (for those that are unfamiliar: what is a CoIIN?) because it's a shining example of how state MCH programs are at the forefront of making sure the rubber does indeed meet the road in efforts to improve AYA well-being. You can read the full announcement of the CoIIN project for more details, but here's the 30 second version:
- Who's involved? There are a total of five multi-disciplinary state teams participating in the CoIIN (Indiana, Minnesota, South Carolina, Wisconsin, and Vermont). AMCHP and NIPN serve as technical assistance supports to all five teams.
- What are the state teams trying to achieve? They're working to increase the rate of major depressive episode screenings among patients aged 12-25 using an age-appropriate screening tool with documentation of a follow-up plan if the screen is positive.
- What's the approach? Simply put, each state has two teams: a public health team and a clinical team. The clinical team will work directly towards improving screening rates in their settings using a quality improvement methodology, while the public health team will work on improving the systems that surround clinics in order to remove barriers to screenings for both providers and the families they serve.
- Still curious? Check out the official CoIIN announcement and/or contact Anna Corona (firstname.lastname@example.org) or Iliana White (email@example.com).
We will be sure to sprinkle updates on this exciting CoIIN work throughout this blog over the next year. Be on the lookout for guest writers, and if we have some brave souls—video updates! Let us know your thoughts below, or on Twitter by using the #ScreenToInterveneForAYAs and tagging us in your post @AMCHP_GrowingUp!
|10/15/2019 2:40 PM||No|
Anna Corona |0||10/3/2019 9:52 AM|
Greetings, and welcome to this blog! My name is Anna Corona and I work for the Association of Maternal & Child Health Programs as the Program Manager for Child & Adolescent Health (AMCHP). AMCHP is one of several partners that make up the Adolescent and Young Adult National Resource Center collaboration, which is led by the UCSF's National Adolescent Health Information Center.*
This blog will be a place where you can come to peruse the latest happenings of the Center's work as well as the latest news and resources related to Adolescent and Young Adult Behavioral Health. Last, but certainly not least, we hope that this can be a space for Title V professionals and their partners to glean perspectives, insights, and ideas as they relate to the posts we share here (please let us know if you'd like to guest write for us! firstname.lastname@example.org). With each blog post we invite you to respond via Twitter (@DC_AMCHP) with reactions, ideas, and questions. We will plan to post a new entry approximately every two weeks, so keep an eye out for us!
To kick us off, I'd like to pose a question to our readers:
What motivates you to dedicate your time and passion to supporting optimal emotional wellness among adolescents and young adults?
To jump start the discussion, I'll share AMCHP's motivations: As an organization committed to the optimal health of women, children, adolescents, and families, the rising rates of major depressive episodes (MDEs) among adolescents (ages 12-17) and young adults (ages 18-25) is troubling. We understand the importance of co-creating environments for and with AYAs that support their emotional well-being to reverse this trend. This co-creation approach is reflected in our most recent strategic plan, where AMCHP prioritizes youth-engaged work to transform the spaces where AYAs seek care, live, study, work, and play.
Let us know your own motivations by tweeting us @DC_AMCHP and including the #ScreenToInterveneForAYAs hashtag.
*The Center is funded by a cooperative agreement with the Maternal and Child Health Bureau of the U.S. Health Resources and Services Administration and focuses on improving the health of adolescent and young adults (ages 10-25) by strengthening the capacity of state maternal and child health programs and their clinical partners to address the needs of those populations.
|10/3/2019 9:52 AM||No|