PSP Child and Youth Mental Health Charter
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What are we trying to accomplish?
Within 8 months, we aim to improve child and adolescents mental health in participating practices as evidenced by:
- KADS scores that have improved by 50% or reduced to non-clinical levels (below 6) for those adolescents screened positive/diagnosed for depression
- SCARED scores that have improved by at least 50% or reduced to non-clinical Levels (below 25) for those children or adolescents screened positive/diagnosed for anxiety
- SNAP-IV scores improved by at least 50% for those children or adolescents screened positive/diagnosed for ADHD
- CGI score of 1(very much improved) or 2 (much improved) for all children and adolescents screened positive/diagnosed for anxiety or ADHD, and for adolescents screened positive/diagnosed for depression.
We aim to accomplish this by focusing on:
•Providing training to primary care practitioners for:
–Enhanced identification and diagnosis of common mental disorders in children and adolescents
–Appropriate use of various evidence-based treatments for the most common mental disorders in children and adolescents
–Appropriate application of standardized methods of measurement in the care of mental disorders in children and adolescents
–Enhancement of physician and MOA knowledge about and awareness of community mental health resources for children and adolescents
–Enhanced family physician collaboration with community partners in the mental health care of children and adolescents
•Improvingthe experience of the health care providers, patients and their families
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How will we know that a change is an improvement?
Measure / Description of Measure- Mental Health identification
- Psychotherapeutic support
- Psychotherapeutic support
- Treatment – Medication
- Medication Adherence
- Team based Care
- Improved health outcomes
Details of Measures
- Mental health identification: # of patients screened positive/diagnosed with the anxiety, ADHD, and depression
Definitions:
- Raw count of the number of children and adolescents who have a positive screen for anxiety, based on in office screening, screening/diagnosis in other ways.
- Raw count of the children and adolescents who have a positive screen for ADHD, based on in office screening, screening/diagnosis in other ways.
- Raw count of the adolescents who have a positive screen for depression, based on in office screening, screening/diagnosis in other ways.
- Psychotherapeuticsupport: % of “identified” patients who are treated with protocol-driven, psychotherapeutic support
Included interventions:
- Mood Enhancing Prescription (MEP)/ Worry Reducing Prescription (WRP)
- Cognitive Behavioural Intervention Skills Manual (CBIS) and other self-management tools
- Referral to Strongest Families BC
- Referral to local community resources
Definition:
- Numerator: Number of “identified” (positive screen/diagnosed) children/adolescents with <specific disorder e.g. anxiety> that have been prescribed at least 1 non-pharmacological intervention
- Denominator: all children identified with <specific disorder e.g. anxiety>
- Psychotherapeutic support adherence: % of “identified” patients offered psychotherapeutic support who follow-through on interventions
Definition:
- Numerator: # of identified patients with <specific disorder e.g. anxiety> who are treated with protocol-driven, non-pharmaceutical interventions and report implementing intervention at home/school in the follow-up visit
- Denominator: # patients with <specific disorder e.g. anxiety> prescribed a non-pharmaceutical intervention.
- Treatment – Medication: % of identified patients who are treated with protocol-driven medications
Definition:
- Numerator:Number of children and adolescents identified with <specific disorder e.g. anxiety>who have been prescribed medication as per CYMH medication algorithms.
- Denominator:Total number of children and adolescents with identified with <specific disorder e.g. anxiety>
- Medication Adherence: % of identified patients who are treated with protocol-driven medications who take prescription as prescribed
Definition:
- Numerator:Number of children and adolescents identified with <specific disorder e.g. anxiety> who have been prescribed medication as per CYMH medication algorithms, who report taking medications as prescribed at the follow-up visit.
- Denominator: Total number of identified children and adolescents prescribed <specific disorder e.g. anxiety>medication.
- Team based care: % of identified patients whom the GP has involved another team member as noted in patient chart.
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Possible examples Include:
- School Counsellors or other school staff
- Specialist physicians
- MCFD CYMH clinicians
- Community support groups
- Member of the patient’s family
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Definition:
- Numerator: Number of children and adolescents identified with <specific disorder e.g. anxiety> where the GP has involved another team member as noted in the patient chart/record.
- Denominator: Number of children and adolescents identified with <specific disorder e.g. anxiety>
- Improved health outcomes: % of identified patients who experience improve health outcomes after at least 3 months of treatment as evidenced by:
All patients:
- Numerator: # of identified patients who have a CGI score of 1 or 2.
- Denominator: all identified patients with anxiety, depression and ADHD
Anxiety:
- Numerator: # of identified patients with anxiety who have at least a 50% improvement from baseline (over 3 months) on the SCARED or who now fall below threshold (25)
- Denominator: All patients identified with anxiety.
Depression:
- Numerator: # of identified patients with depression who have at least a 50% improvement from baseline (over 3 months) on the KADS or who fall below threshold (6)
- Denominator: All patients identified with depression.
ADHD
- Numerator : # patients diagnosed with ADHD who have at least a 50% improvement from baseline (over 3 months) on the SNAP-IV.
- Denominator: All patients identified with ADHD.
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