ABSTRACT
OBJECTIVE: To investigate the feasibility of establishing ongoing, early identification services for mental health problems in school settings. METHOD: School counselors and other mental health professionals (N = 41) in middle, junior, and high schools (N= 23) were given training and supervision in the administration of an evidence-based mental health assessment tool, the Voice Diagnostic Interview Schedule for Children IV (DISC-IV), over the course of 1 1/2 school years. RESULTS: During the study, 530 students were selected to be assessed with the DISC, and 72% were confirmed to be at risk for a mental health problem (DISC+). Among DISC+ cases, 71% had never been in treatment before. The most common problems identified by the DISC were symptoms related to suicide (28%), social phobia (20%), attention-deficit/ hyperactivity disorder (19%), and oppositional defiant disorder (19%). Based on schools' recommendations, 82% of parents with DISC+ children agreed to make an appointment for a follow-up evaluation. Of DISC+ children whose parents agreed to seek further evaluation, 65% of them were evaluated by a health or mental health professional within 2 weeks. CONCLUSIONS: Use of a computerized, evidence-based mental health assessment tool is a feasible strategy for providing early mental health identification services in schools and can help to bridge the gap between mental health providers and the unmet needs of children who are at risk for mental health problems within the community.
Subject(s)
Inservice Training , Interview, Psychological , Mass Screening/organization & administration , Mental Disorders/diagnosis , Outcome Assessment, Health Care , School Health Services/organization & administration , Adolescent , Adult , Child , Early Diagnosis , Evidence-Based Medicine , Feasibility Studies , Female , Humans , Male , Mass Screening/statistics & numerical data , Mental Disorders/epidemiology , Mental Disorders/therapy , Middle Aged , Referral and Consultation , School Health Services/statistics & numerical data , United States/epidemiologyABSTRACT
Agencies regulating US psychiatric inpatient facilities require face-to-face patient assessments by physicians within one hour of the use of seclusion or restraint. In a pilot study, we compared face-to-face and remote assessments using videoconferencing in relation to response times and physicians' ratings of aspects of seclusion or restraint events involving paediatric patients at a private psychiatric hospital. Fifteen paired face-to-face and remote assessments were compared. Remote assessments occurred more rapidly than face-to-face assessments and more took place while seclusion or restraint was still being used. There was little disagreement between the physicians' ratings in face-to-face and remote assessment conditions. Remote assessment may therefore be a rapid and reliable method for physicians to evaluate the use of seclusion and restraint.
