Screening for risky behaviour and mental health in young people: the YouthCHAT programme

Abstract

BackgroundThe prevalence of mental health concerns and risky health behaviours among young people is of global concern. A large proportion of young people in New Zealand (NZ) are affected by depression, suicidal ideation and other mental health concerns, but the majority do not access help. For NZ indigenous Māori, the burden of morbidity and mortality associated with mental health is considerably higher. Targeted screening for risky behaviours and mental health concerns among youth in primary care settings can lead to early detection and intervention for emerging or current mental health and psychosocial issues. Opportunistic screening for youth in primary care settings is not routinely undertaken due to competing time demands, lack of context-specific screening tools and insufficient knowledge about suitable interventions. Strategies are required to improve screening that are acceptable and appropriate for the primary care environment. This article outlines the development, utilisation and ongoing evaluation and implementation strategies for YouthCHAT.YouthCHATYouthCHAT is a rapid, electronic, self-report screening tool that assesses risky health-related behaviours and mental health concerns, with a ‘help question’ that enables youth to prioritise areas they want help with. The young person can complete YouthCHAT in the waiting room prior to consultation, and after completion, the clinician can immediately access a summary report which includes algorithms for stepped-care interventions using a strength-based approach. A project to scale up the implementation is about to commence, using a co-design participatory research approach to assess acceptability and feasibility with successive roll-out to clinics. In addition, a counter-balanced randomised trial of YouthCHAT versus clinician-administered assessment is underway at a NZ high school.ConclusionOpportunistic screening for mental health concerns and other risky health behaviours during adolescence can yield significant health gains and prevent unnecessary morbidity and mortality. The systematic approaches to screening and provision of algorithms for stepped-care intervention will assist in delivering time efficient, early, more comprehensive interventions for youth with mental health concerns and other health compromising behaviours. The early detection of concerns and facilitation to evidence-based interventions has the potential to lead to improved health outcomes, particularly for under-served indigenous populations.

Youth version, Case‐finding and Help Assessment Tool (YouthCHAT): An electronic, psychosocial screener for young people with long‐term physical conditions

“…The Youth version of the electronic Case‐Finding and Help Assessment Tool (YouthCHAT) is a self‐report, tablet‐based screener that covers 13 domains: smoking, drinking, recreational drug use, problematic gambling, depression, anxiety, sexual health, eating and conduct issues, stress, exposure to abuse, anger management and physical activity. Broadly matched to the areas of Home, Education/Employment, Activity, Drugs, Sexuality, Suicide/Depression, Safety (HEEADSSS) assessment following consensus‐based consideration of criteria by the research team, YouthCHAT includes three validated screens: for substance abuse (Substances and Choices Scale (SACS)), depression (Patient Health Questionnaire – Adolescent Version (PHQ‐A)) and anxiety (Generalized Anxiety Disorder scale – 7 item (GAD‐7)).…”

A Face-Aging App for Smoking Cessation in a Waiting Room Setting: Pilot Study in an HIV Outpatient Clinic

“…These mostly comprise digitized screening and early detection tools. The majority of this work focuses on mental health or the prediction of mental disease [ 59 , 64 - 66 , 68 , 69 , 74 , 77 ], and only a few publications have focused on predictors of chronic disease in general, including substance abuse [ 63 , 65 , 68 , 70 , 77 ]. However, helping physicians to identify smokers is only one aim of the intervention presented here; we think it is at least likewise important to investigate its direct effect on quitting behavior in future studies.…”

Consider the root of the problem: increasing trainee skills at assessing and addressing social determinants of health

“…The SPs were all high school juniors or seniors (aged [16][17][18], recruited through an intensive healthcareers exploration program. Overall, 13% of the SP trainees were African American, 65% were Latinx, 9% were Asian, and 4% were Caucasian.…”