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#ScreenToInterveneForAYAs: Adolescent and Young Adult Behavioral Health Blog

 

Welcome to 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, #ScreenToInterveneForAYAs. 

 

If you’d like to submit a post, please contact Anna Corona (acorona@amchp.org) to have your writing featured!

  
Picture Placeholder: Anna Corona
  • Anna Corona
01/22/2020 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

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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:

  1. 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.
  2. 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.

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1/22/2020 3:01 PMNo
  
Picture Placeholder: Anna Corona
  • Anna Corona
01/7/2020 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 Health.  

Convening Stakeholders to Create a Plan for Adolescent Health in Minnesota

By: Julie Neitzel Carr, Minnesota's Adolescent Health Coordinator

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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.

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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 (julie.neitzelcarr@state.mn.us), MN's Adolescent Health Coordinator.

Interested 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 PMNo
  
Picture Placeholder: Anna Corona
  • Anna Corona
012/4/2019 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:

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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 AMNo
  
Picture Placeholder: Anna Corona
  • Anna Corona
011/12/2019 4:12 PM

Last week, 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 and professionals: 


·    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 use disorders


·    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. 


To learn 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!

 

Our next 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!

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11/12/2019 4:12 PMNo
  
Picture Placeholder: Anna Corona
  • Anna Corona
010/30/2019 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 Champions!  

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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 (right)


10/30/2019 3:17 PMNo
  
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  • Anna Corona
010/15/2019 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 (acorona@amchp.org) or Iliana White (iwhite@amchp.org).

 

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 PMNo
  
Picture Placeholder: Anna Corona
  • Anna Corona
010/3/2019 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! acorona@amchp.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 AMNo

*The AYAH-NRC is funded by a cooperative agreement with the Maternal and Child Health Bureau of the U.S. Health Resources and Services Administration. The center's work 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. The AYAH-NRC collaboration is led by the National Adolescent and Young Adult Health Information Center at the University of California, San Francisco, in partnership with AMCHP, the University of Minnesota's State Adolescent Health Resource Center, and the University of Vermont National Improvement Partnership Network.