1. Assessment of Risk and Protective Factors

2. What assessment tools is your SBHC using???

3. During an office visit… Comprehensive Risk Assessment Comprehensive Risk Assessment Asset Checklist Asset Checklist Stress/Risk Factor Assessment Stress/Risk Factor Assessment

4. COMPREHENSIVE RISK ASSESSMENT

5. Risk Assessment A comprehensive annual risk assessment and biennial physical exam are essential to detecting and addressing all important health concerns of the student. A comprehensive annual risk assessment and biennial physical exam are essential to detecting and addressing all important health concerns of the student. - NASBHC CQI Tool

6. Risk Assessment injury injury safety safety violence violence diet and exercise diet and exercise dental dental substance use and passive exposure substance use and passive exposure abuse family relationships school friends mood and emotional health sexuality Must be developmentally appropriate and is expected to cover: - NASBHC CQI Tool

7. Risk Assessment Tools

8. Guidelines for Adolescent Preventive Services (GAPS) Guidelines for Adolescent Preventive Services (GAPS) http://www.ama-assn.org/ ama/pub/category/1980.html http://www.ama-assn.org/ ama/pub/category/1980.html Bright Futures Bright Futures http://www.brightfutures.org American Academy of Pediatrics American Academy of Pediatrics http://www.aap.org/policy/periodicity.pdf

9. Risk Assessment Tools Pediatric Symptom Checklist Pediatric Symptom Checklist http://www.massgeneral.org/psc Child Health and Illness Profile (CHIP) Child Health and Illness Profile (CHIP) http://chip.jhu.edu

10. HEADSS interview Home Home Education Education Activity Activity Diet Diet Safety Safety Sexuality Sexuality

11. The Asset Checklist Self-report Self-report 40 developmental assets 40 developmental assets Identifies qualities in youth that can be enhanced to promote resiliency. Identifies qualities in youth that can be enhanced to promote resiliency.

12. Scoring for the Asset Checklist External assets External assets ● Support – (Questions 1-6) ● Empowerment – (Questions 7-10) ● Boundaries and expectations – (Questions 11- 16) ● Constructive use of time – (Questions - 17-20) Internal assets Internal assets ● Commitment to learning – (Questions 21-25) ● Positive values – (Questions 26-31) ● Social competencies – (Questions 32-36) ● Positive identity – (Questions 37-40)

13. Stress-Risk Factor Assessment Ask Ask ● “What 3 things do you think are causing you the most stress lately?”; ● “What 3 things do you think are causing your family the most stress lately?” ● “What 3 things do you think are most stressful about your school?” ● “What 3 things do you think are most stressful about your neighborhood?” Mark the student’s top three areas of stress with 1, 2, and 3. Mark the student’s top three areas of stress with 1, 2, and 3. Place a checkmark beside other areas of stress or risk factors that apply for this student Place a checkmark beside other areas of stress or risk factors that apply for this student

14. Stress-Risk Factor Assessment Ask Ask ● “What 3 things do you think are causing you the most stress lately?”; ● “What 3 things do you think are causing your family the most stress lately?” ● “What 3 things do you think are most stressful about your school?” ● “What 3 things do you think are most stressful about your neighborhood?”

15. Stress-Risk Factor Assessment Mark the student’s top three areas of stress with 1, 2, and 3. Mark the student’s top three areas of stress with 1, 2, and 3. Place a checkmark beside other areas of stress or risk factors that apply for this student Place a checkmark beside other areas of stress or risk factors that apply for this student

16. Considerations In Assessment Selection Be sensitive to age, sex, language, and culture Be sensitive to age, sex, language, and culture Be relevant to their needs or risk factors Be relevant to their needs or risk factors Practicality of implementing in your practice Practicality of implementing in your practice Instruments should be “user friendly” Instruments should be “user friendly” Capture the information you need Capture the information you need Be measurable Be measurable Fit with your style of practice Fit with your style of practice There is no best way There is no best way

17. How do you conduct the risk assessment? Paper and pencil – done by student Paper and pencil – done by student Computer based Computer based Provider interview of student at the time of the examination Provider interview of student at the time of the examination Provider interview of student at a time apart from the examination Provider interview of student at a time apart from the examination What works in your setting? What works in your setting?

18. Documentation of Risk and Protective Factors Documentation may take many forms… Documentation may take many forms… ● Inclusion of strengths/assets/protective factors in intake evaluation, progress notes, and/or treatment plan ● Checklist of risk and protective factors ● Assessment instruments (e.g., comprehensive risk assessment, asset checklist, etc.)

19. Getting the assessment done: Distribution of work Identifying components of the work Identifying components of the work Identifying team roles Identifying team roles Shared Responsibility Shared Responsibility Staff Training Staff Training

20. Now What?: Assessment Follow-up Is there a referral system in place to follow-up on identified mental health problems? Is there a referral system in place to follow-up on identified mental health problems? ● Internal referrals ● External referrals

21. Strategies to Facilitate Referrals Internal referrals: Internal referrals: ● Referral log ● Referral form with feedback form ● Interdisciplinary case conferences ● Follow-up documentation in charts External referrals: External referrals: ● Community resource directory ● Established relationships with community mental health providers/sponsoring organization