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,
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Anna Corona |0||2/25/2021 2:46 PM|
By: Maura Leahy, MPH, CHES, Program Analyst, Child & Adolescent Health at the Association of Maternal & Child Health Programs
As February comes to an end, so does the annual observance of Teen Dating Violence Awareness Month (TDVAM). We wanted to bring additional attention to this important issue by highlighting teen dating violence (TDV) strategies and resources that Title V Maternal and Child Health (MCH) programs use that can elevate TDV prevention year-round.
Adolescence is a unique period of opportunity and growth when young people are making deeper connections with their peers, developing interests and passions, and testing the waters of romantic relationships. This range of relationships are natural parts of a young person's brain and identify development, but it is vital that these relationships are safe and healthy. Adults have a role to play by creating and supporting safe environments in which adolescents can thrive and grow. Title V can also play a role in supporting programming and capacity geared towards preventing TDV so that adolescents and young adults can experience this stage of development in a safe and healthy manner.
What is TDV and why is it an issue? TDV is a type of intimate partner violence (IPV) that can include four types of behavior: physical violence, sexual violence, emotional or verbal abuse, and stalking. These behaviors can happen in-person or electronically. Since emotional abuse is most common among youth, it is important to recognize the warning signsso that red flags of potential TDV are not overlooked. TDV is much more common than adolescents and adults may realize: 1 in 3 three teens in the U.S. will experience some form of dating violence. Victims of TDV are more likely to experience symptoms of depression and anxiety and to have suicidal thoughts, and these consequences can be long-lasting. Additionally, most adult survivors of IPV first experienced violence when they were adolescents (National Intimate Partner and Sexual Violence Survey, 2015).
What is Title V doing to prevent TDV? According to their recent MCH action plans, many states incorporate healthy relationship programming through a variety of federal funding streams (such as the Personal Responsibility Education Program, Sexual Risk Avoidance Education Program, Rape Prevention and Education Program), and through broader Positive Youth Development programs. Two main strategies emerged in these efforts: implementing evidence-based curricula and outreach/media campaigns. Here's a snapshot of what some states are doing:
- Evidence-Based or Trauma-Informed Curricula
- Alaska is developing a Fourth R and Healthy Relationships Plus Program online training that will include resources for parents and educator on talking with youth about healthy relationships. They are also supporting a statewide training and dissemination of the Coaching Boys Into Men curriculum.
- Florida is implementing the Green Dot strategy in north Florida High Schools. Green Dot focuses on shifting cultural norms and emphasizes personal responsibility and prevention through behavior modeling.
- Massachusetts' Safe Spaces for LGBTQ youth program provides trauma-informed support that is specific to LGBTQ youth and issues they face including partnership violence.
- Outreach and Media Campaigns
Resources for Title V programs to promote throughout the year:
Broader Violence Prevention/IPV Resources:
|2/25/2021 2:46 PM||No|
Anna Corona |0||1/26/2021 3:27 PM|
Results from many Title V 2020 Needs Assessments confirmed that access to mental health care providers is a challenge for improving mental health status among the adolescent population. In fact, several state Title V programs cited mental health workforce provider shortage as a significant barrier to linking adolescents to appropriate treatment when screening positive for depression or other conditions. Given the prevalence of this shortage nationally, a recent Journal of Pediatrics article discussed the promise of Child Psychiatry Access Programs (CPAP) as a tool for primary care providers to feel more comfortable providing mental health care to their patients. CPAPs provide primary care physicians with access to child psychiatrists via same-day telephone consultations that cover questions related to diagnosis, management, and care coordination for their patients. CPAPs are viewed as a promising strategy for gap-filling services while experts continue to explore ways to grow the mental health provider workforce.
The article emphasizes that the greatest challenge to the sustainability of CPAPs is a consistent funding source. Title V programs, with their flexible block grant funds, are in a unique position to directly support CPAP programs as a strategy for addressing adolescent mental health. Montana's Title V program has done this by contracting with the state's Billings Clinic to establish a toll-free access line for primary care providers to call and consult with the clinic's Child and Adolescent Psychiatrists during daytime hours. Other Title V Programs also support federally-funded programs to implement their state's CPAP, including:
- Colorado, which contracted with the Pediatric Mental Health Institute and Department of Psychiatry at the University of Colorado to implement the Colorado Pediatric Psychiatric Consultation and Access Program; and
- Kansas, which established a provider consultation line that supports primary care physicians and clinicians in treating behavioral health conditions within their practices.
Additionally, Title V Programs have been working to amplify and disseminate the message of available CPAPs to provider networks in their states, including:
- Iowa, which educates and markets their state's 24/7 Psychiatry Consultation line to primary care providers utilizing resources enabled through the Health Resources and Services Administration's Pediatric Mental Health Care Access Program; and
- New York, which partners with their state's Office of Mental Health to increase awareness of the expansion of Project TEACH (NY's model for pediatric psychiatric consultations).
Finally, Title V programs can support CPAPs by providing evaluation services to serve as an important data source for communicating the importance of this resource for improved access to mental health care. For example, the Wisconsin Title V program supports implementation and evaluation of their state's Child Psychiatry Consultation Program in collaboration with the Medical College of Wisconsin.
For those states where a CPAP does not currently exist, the article recommends building a coalition of stakeholders who are interested in developing this for their state. Since Title V programs are well positioned to serve as conveners, this could present as an opportune starting point in such states. Once coalitions are formed, suggested next steps include contacting nearby states who have active CPAPs to learn more about how they were successfully started and implemented.
 Sulivan, K., George, P., and Horowitz, K. Addressing National Workforce Shortages by Funding Child Psychiatry Access Program. Pediatrics 2021;147; DOI: 10.1542/peds.2019-4012
|1/26/2021 3:27 PM||No|
Anna Corona |0||12/17/2020 11:24 AM|
Happy holidays #ScreenToInterveneForAYAs blog readers! First and foremost, thank you for your readership this year—we hope you've found the posts to be informative and helpful for your work. While thinking about how we wanted to wrap up our blog in 2020, we realized the importance of pausing to promote the value of self-care for our readers. Understanding that we can't take care of others if we are not well ourselves, the AMCHP team wanted to learn what you do to take care of yourselves in the midst of a global pandemic, to bring your best self to this important work. Tina Palmer, Adolescent Health Coordinator for the state of Iowa, has graciously shared her reflections (below) on the importance of self-care and how she practiced it this year. A million thanks to Tina for sharing her story—we hope you all find some inspiration for yourselves. For additional ideas, check out the Association of State and Territorial Health Official's self-care strategies and tools for public health professionals.
The year 2020 began as any other. Life was chugging along as usual and I was in the midst of planning graduation for my step-daughter. The typical Iowa graduation open house…food, guests, and pictures galore. The date was set and the invitations were ordered. Spring Break hit and suddenly the first cases of COVID-19 began popping up a little too close to home. And then, March 17th. Restaurants were suddenly closed down, school was put on hold, and gatherings were limited. My work pivoted to temporary telework from home. This will be short-lived, right? We have senior trip in April, and then Prom, Graduation, and then her senior season of softball (we play summer ball in Iowa). And anyone that knows me knows how much I LOVE SOFTBALL! We cannot miss our softball season! There were other family plans happening as well, as my oldest daughter was in the early stages of planning her November wedding. November is forever away, we will be fine then. Certain of it!
I sat in my "home office" every day and tuned in to the Governor's press conferences for updates. Every. Single. Day. March came and went. Schools remained closed. Senior trip was postponed. Track season cancelled. April came and went. Graduation is virtual with a town parade to celebrate the graduates. A much smaller graduation open house was held. It's now May. Softball practice should be starting. We will make a repeat appearance at the state tournament this year, so the season has to happen. There is talk that Iowa could be the first state to allow high school sports. There will be new protocols and mitigation strategies, but they will get to play. And that our girls did! In fact, they took every advantage of being able to play their last season together and not only made that repeat appearance to state, but WON! Well, there's some good news amongst all this chaos.
Chaos. That's what I call it. Yes, we won the state championship. But what about the rest of my life? I continued to work from home. Loving my commute, but missing the day-to-day interactions with people. I NEED people. Conversations with the dog just don't quite fill the gap. Those daily press conferences continue, maybe not daily, but I'm still watching. Every. Single. Time. I'm still watching the news. Every. Single. Day. It's taking a toll.
Here we are in December. The pandemic continues. The wedding happened. Not the way it was originally planned, but still absolutely PERFECT and the bride was absolutely stunning. I might be a bit biased. Work from home continues, but you know what? I don't have to worry about traffic and winter driving. I am listening to music…without earbuds. I couldn't do that in my cubicle! Video calls give me the people interaction that I need. I can take a quick break and do some yoga poses to stretch and re-center in the privacy of my living room. I can look out my front window right next to my desk and see the beauty of the bright white snow that fell over the weekend.
I have always been a very optimistic person, but that can be very difficult in the uncertain times that we are living. Seeking the positivity every day has helped. Oh, and so has turning off the news. I don't watch the press conferences anymore. I don't watch the news every day. I seek the information I need to know and let the rest go. I breathe, I laugh…loudly, I find refuge in music and sing along…loudly, I craft, I seek inspiration, I give a lot of grace to others and myself, and I focus on the positives that exist. There are a lot of them when you look. Nothing has become more important and there has been much to learn. My eternal optimism persists like never before. Take care of yourself first. Always.
|12/17/2020 11:24 AM||No|
Anna Corona |0||11/13/2020 10:24 AM|
Adolescents are in a phase of their social, emotional, and identity development where they are seeking more opportunities to be independent as well as spend time with their peers, however due to the pandemic, they are less able to access those opportunities in an environment where social distancing is necessary. The New York Times (NYT) published an article emphasizing that the pandemic presents these unique challenges for adolescents. Different survey data highlight that the effects of the pandemic vary among groups of adolescents and depend greatly on context. Below is a summary of the results of two different surveys featured in the article:
- The Institute for Family Studies and the Wheatley Institution surveyed 1500 adolescents between May and June and found that overall, the proportion of teens who reported feeling depressed and lonely had decreased since 2018. The survey's authors postulate that these improvements may be attributable to increased amounts of sleep during the pandemic and also observed that a majority of respondents indicated feeling closer to their families. Notably, this survey found that adolescents facing food insecurity reported higher rates of depression.
- Wellbeing.org surveyed 1000 adolescents in early October and found less optimistic results. Nearly half of respondents indicated that their mental health had worsened since the start of the pandemic and more than half reported that their social lives had been negatively impacted due to the pandemic. Additionally, this survey found that outside of the pandemic, climate change and the struggle for racial justice were major sources of stress for respondents.
What does this mean for Title V MCH programs? To start, the effects of the pandemic on young people cannot be generalized at the national level. It's important to assess adolescents' experiences in their specific contexts to drill down to the root causes of behavioral health challenges during COVID and beyond. There is a critical need to address food insecurity among adolescents and their families as well as climate change, racial injustice, and other societal stressors that impact their lives and development. Approaching these issues with a social justice lens will be an important strategy for preventing adverse health outcomes for the remainder of this pandemic and beyond.
As public health practitioners consider replicating and/or adapting the surveys linked above, they can also think about convening youth-centered focus groups, working with youth advisory councils, or hosting virtual listening sessions or town halls (with youth as facilitators) to understand the root causes of stress and behavioral health challenges among adolescents in your specific jurisdiction. It's essential to identify and connect those adolescents to quality care who are living with behavioral health challenges, but also equally important to implement a long-term plan for addressing the complex root causes driving behavioral health challenges among adolescents in your setting.
In September's blog post, we emphasized the importance of elevating and amplifying suicide prevention resources year-round. To live up to that call to action, we are sharing this list of resources here again. Be sure to check out the list as it offers tailored resources and diverse messaging for adolescents and young adults: Closing out Suicide Prevention Awareness Month: Resources to Promote and Utilize Year-Round.
 Malo, A. The Hardest Fight to Have With Your Teen (October 2020). Accessed via: https://www.nytimes.com/2020/10/28/parenting/teens-stress-lonely-coronavirus.html on October 30, 2020.
|11/13/2020 10:24 AM||No|
Anna Corona |0||9/28/2020 2:34 PM|
According to the National Alliance on Mental Illness (NAMI), Suicide Prevention Awareness Month (September) serves as an opportunity to highlight resources for suicide prevention and share the stories of those affected by suicide. As such, in observance of Suicide Prevention Awareness Month, this post is dedicated to sharing:
- The story of the South Carolina maternal and child health (MCH) program's effort to support their NAMI state chapter's Ending the Silence Campaign
- Resources that MCH Programs can help promote and disseminate in their efforts to reach adolescents & young adults (AYAs) directly
- Professional development opportunities as well as tools for implementing suicide prevention strategies for the AYA population
The South Carolina MCH Story:
As participants in the Adolescent & Young Adult National Resource Center's AYA Behavioral Health learning collaborative,
the South Carolina team has strategically focused their resources on building partnerships with organizations around the state that are already addressing AYA emotional well-being, including the state's local NAMI chapter. They are supporting SC NAMI in implementing their "Ending the Silence" campaign
in high schools across the state. This campaign educates students, school staff, and the larger community on the signs and symptoms of common mental health conditions and offers clear steps to take if an individual or loved one is in need of support. With the pandemic forcing students to spend less time physically inside their schools, the SC team has been proactive in promoting the NotOK app
as a tool for youth that are experiencing mental health issues such as depression and axiety but can't reach their typical resources in person. The app is designed and maintained by two young adults and their trusted furry companion (check out their "about us
Check out NAMI's local chapter search
page to identify the one closest to you and reach out to learn how your MCH program might be able to help spread their messaging, particularly during the pandemic.
Resources to Share & Amplify Year-Round:
- National Suicide Prevention Lifeline: 800-273-8255 (English) 888-628-9454 (Spanish)
- The Trevor Project: TrevorLifeline (1-866-488-7386), TrevorChat, and TrevorText (Text START to 678-678)
- We R Native: a resource developed by Native youth for Native youth for achieving balance physically, spiritually, and mentally
- NotOK app: developed for youth by youth, this app provides young people with a way to connect with a trusted adult during times when emotional support is needed
Professional Development & Implementation Resources to Explore:
This graphic was accessed via NAMI's Awareness Resources page. NAMI has a library of graphics, free of charge, that your organization can use across social media sites to help raise awareness. Remember-these graphics and messages can and should be promoted year-round!
|9/28/2020 2:34 PM||No|
Anna Corona |0||8/26/2020 9:57 AM|
White, MPH, CHES, CPH
Program Manager, Adolescent Health
Maternal & Child Health Programs
In the era of COVID-19, there is an increased spotlight on
the emotional and mental tolls that this unprecedented pandemic has fueled.
When it comes to adolescents and young adults (AYA), their experience in
navigating back to school, college campus, or their return to the workforce can
be met with stress, anxiety, and a lot of uncertainty. In a recent learning
session for the AYA Behavioral Health CoIIN,
Dr. Sharon Hoover of the National
Center for School Mental Health discussed strategies to address students’
and school employees’ needs as they return to some form of instruction, whether
remote, in-person, or a hybrid approach. As part of her presentation, she
touched on the concept of “Always and Now”. With coronavirus, many of our
planned public health strategies and activities, including those related to AYA
mental health, may have become suspended or shifted to accommodate more
pressing emergency responses. When able to focus on the mental health needs of
AYAs, strategies are changing to accommodate the current environment we are
living in. With schools resorting to spring instruction completely online, stay
at home orders, and sometimes the need to quarantine, the massive isolation of
young people from their friends, classmates, and other supportive factors can have
its toll. There may be an increased spotlight on the implications of being
isolated and not being able to access the care or support needed to adjust and
live through this modified state of society. Unusual, unprecedented circumstances—that
is the Now. But what about the Always?
The concept of Always is a grouping of those ideal,
core principles that we as providers, public health practitioners, and adult
champions should be embedding in our work and systems that serve young people. Pre-COVID,
adolescents were experiencing a variety of mental health conditions, with the
top four most prevalent being ADHD, anxiety, diagnosed behavioral problem, and
depression (Danielson et al., 2018, Ghandour et al., 2019). The rates of
Major Depressive Episode (MDE) have been steadily increasing since 2008 among 12-17
year olds (NSDUH, SAMSHA, 2018); increased suicide rates, especially
among females, Black and Latinx, and LGBTQ youth, has been cited as a growing
concern for state Title V and MCH programs over the past several years. The
bottom line is that youth have been dealing with increasing challenges of
navigating their development while trying to understand and maintain their
status of mental health since before the pandemic. We can’t simply STOP the work we Always do to improve AYA mental health...how do we
ensure young people don’t become further disenfranchised? The prioritization
and intention around strategies to address mental health and emotional
well-being can’t be put on hold because COVID-19 came along. If anything, the
pandemic may exacerbate some of the adverse experiences or lack of social
support networks that youth experience. In a recent plenary discussion at the 2020
AMCHP virtual conference, several peer and young adult leaders shared their
perspectives regarding mental health, resilience, and how we can support young
people. A key theme that kept surfacing is the notion of investment—investing
in their support now, so that they can thrive in the present, not just in the
We should Always have the calling to ensure that AYA mental health needs and concerns are met with empathy and action. Often,
we see their mental health challenges be dismissed as a phase, a temporary
episode “that will go away on its own.” The
unmet needs of adolescents amplify into unmet needs as young adults. Stress and
trauma can continue to be multigenerational. It is easy for young people to
feel isolated, disconnected, frustrated, and anxious, especially with how
drastically COVID-19 has changed our ways of interacting. In a recent MMWR Report
from CDC, a survey found that 25% of young adult respondents ages 18-24 have
seriously considered suicide in the past 30 days. Think about that—1 in 4 young
adults, the highest out of all the age groups surveyed.
Prior to Coronavirus, and after, a significant amount of
youth’s emotional well-being or mental health concerns were not addressed nor
treated and thus left to exacerbate. We need to Always make sure we
acknowledge their challenges and experiences; support their development in healthy
spaces; and encourage them to seek care and act Now to protect and
enhance their present and future development. There has been the optimistic mindset regarding the pandemic
that “this too shall pass.” Let’s hope the heightened awareness, empathy, and
acknowledgement of AYA mental health does not pass also, but rather remains a
key priority to monitor and support, Always, and especially starting Now.
|8/26/2020 9:57 AM||No|
Anna Corona |0||7/23/2020 2:20 PM|
In preparation for the start of another potentially virtual school year, The Adolescent and Young Adult Behavioral Health CoIIN state teams convened online earlier this month to hear from experts on strategies for supporting student well-being, including mental health, in the distance learning setting. Included in the group of experts were two student leaders representing the Moving In New DirectionS (M.I.N.D.S.) group of Rice County Minnesota, a school-based student group working to support the mental health of their peers. Recently, the M.I.N.D.S. team administered a survey to fellow students in four high schools and two middle schools to understand the state of mental health among their peers, how COVID-19 had affected their mental health, and how they were coping given the switch to a fully virtual school setting. A major takeaway from this survey was that students were missing their connections to their classmates, teachers, and school counselors. Because of this, the CoIIN state teams posed several questions to the M.I.N.D.S. leaders on how to best reestablish these connections in an online setting. The students suggested the following strategies:
- Prioritize building trust between new teachers and/or counselors and their students, especially at the start of a new school year. Suggestions for how to facilitate trust-building online included:
Utilize innovations, such as the free CloseGap software, to regularly check-in on student well-being. It's important that these check ins come from a trusted teacher or school counselor rather than from administration, which may not have achieved the same level of rapport as a teacher. Consider that not all students are comfortable turning on their webcams because they may not want teachers/peers to see the space where they live and be open to audio-only check ins. Training on how to pick up on cues without being able to read body language or gauge appearance is important for teachers and/or counselors that are operating in a virtual environment where their students may not feel comfortable using their webcams.Connect students directly to relevant mental health/wellness resources and don't assume that students—or even the staff at the schools they attend—are aware of the available virtual resources for supporting their mental health and wellbeing.
- One-on-one meetings between teacher and/or counselor and each student to get to know each other with sufficient time to dive into deeper issues
- Encourage teachers to organize study groups for their students where they make themselves available to pop in and assist with assignments
- Create a "Wellness Wednesday" class that is mandatory where health teachers speak on the topic of wellness or facilitate a conversation with the students regarding their emotional well-being
- Create space at the beginning of regular class and/or study group interactions to ask students how they're doing or feeling
In summary, intentionality around scheduling time for teachers and school counselors to engage with their students is crucial in building the trust required for students to ask for help when they need it. As MCH professionals, one step we can take to assist these efforts is to ensure that our partners in the local school systems are aware of relevant mental health resources and services so that our partners in education can share them with students during their trust-building events. As the technical assistance and training center with a focus on advancing research, training, policy, and practice in school mental health, The National Center for School Mental Health (NCSMH) has a treasure trove of resources, including:
|7/23/2020 2:20 PM||No|
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|