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Under-recognition of Child Mental Health Problems
Despite well-documented levels of child mental health disorders in our nation’s youth, studies have repeatedly shown that most children with mental health problems are not identified and do not receive needed care. These children are not readily identified or referred for treatment due to concerns about stigmatization as well as a pervasive lack of awareness/knowledge among the general public, providers, and parents. Therefore, there is a need for consistent messages based on evidence-based information concerning what are the most pertinent early warning signs of mental illness; how to determine which children are at risk, and what steps to take when children exhibit such early warning signs.
The Need for Warning Signs, aka "Action Signs"
To address these and related problems, the Surgeon General issued a “call to action” in January 2001, urging the development of “early warning signs” or indicators that when present, warrant additional professional assistance. In response, CMHS and NIMH awarded a contract to REACH Director Peter S. Jensen (while he was at Columbia University) to identify a set of indicators using rigorous research methods, guided and further refined with input from parents, doctors, teachers, and youth. Working with a Steering Committee composed of experts in the fields of epidemiology, public policy, and advocacy, staff identified a number of indicators or “action signs” that if present in a child may warrant professional attention. These warning signs have been formed and sculpted by two methods: analysis of large epidemiological data sets and feedback from various stakeholders in nationwide focus groups. The current list consists of 11 indicators, and have also been translated into Spanish.
Recently, the Center for Mental Health Services of the Department of Health and Human Services, the Centers for Disease Control, the National Alliance for Mental Illness (NAMI), the American Academy of Pediatrics, the American Academy of Child & Adolescent Psychiatry, and 14 other national family and professional organizations endorsed the final wording and use of the Action Signs.
A research paper supporting the rationale and scientific validity of the action signs will be published in the most prestigious journal for children's health, Pediatrics, and released to the press, October 28, 2011. Copies of this paper, "Overlooked and Underserved: "Action Signs" to Improve Recognition of Child Mental Health Problems," are available from the lead author, REACH President Peter S. Jensen, MD, on or after the embargo date. Members of the press may contact the REACH Institute to obtain a copy.
The final "action signs" are a powerful, evidence based assessment and screening tool for assisting doctors, teachers, and others who work with children to screen for mental health disorders in children. Without such mental health screening tools, more than half of children with mental health problems will not be identified, and will not receive urgently needed help.
Support & Funding
These warning signs were developed under a contract from SAMHSA/HHS, contract number 520712. The views, policies, and opinions expressed are those of the authors and do not necessarily reflect those of SAMHSA or HHS.
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