Teen Mental Health Project

描述（由申请人提供）： 青春期是心理健康问题常见的时期。一生中有一半的心理健康障碍出现在14岁之前。尽管大多数青少年每年都在初级保健中就诊，但只有三分之一的抑郁青少年在没有使用筛查工具的情况下在常规健康检查中被发现。在新英格兰农村，每12个青少年中就有一个在健康检查中有抑郁或自杀的风险。有证据表明，一个协作护理系统，其中青少年进行抑郁症筛查，提供者接受培训和支持，以评估青少年，办公室工作人员接受培训，以提供后续行动和转介将导致更好的结果。美国预防服务工作组推荐这种方法。然而，大多数临床医生，特别是在小型农村诊所，发现改变常规护理是压倒性的，并且缺乏资源来建立与心理健康服务相关的增强办公室护理。通过实践研究网络将临床医生联系起来，为区域实践提供了支持，以实施创新变革，加强患者护理。 通过AHRQ的支持，达特茅斯COOP项目和CECH基于实践的研究网络（PBRN）将与达特茅斯希区柯克和区域心理健康关键利益相关者合作，建立培训临床医生及其办公室工作人员的结构，增强心理健康咨询选择，为临床医生提供青少年精神病学投入，并支持办公室的变化，以应对青少年抑郁症。达特茅斯合作项目将提供工具和工作人员，以协助与该办公室一起提高质量，并形成一个持续的实践和利益攸关方小组，以持续改善初级保健青少年心理健康服务的提供。 公共卫生相关性： 拟议的青少年心理健康方案解决了影响青年的一个主要公共卫生问题。到19-20岁时，23%的年轻人有过抑郁症发作，自杀是全国15-24岁奥尔兹的第三大死亡原因。加强初级保健筛查和管理可在预防和早期治疗方面发挥重要作用。

DESCRIPTION (provided by applicant): Adolescence is a time when mental health issues are common. Half of all lifetime mental health disorders emerge by age 14. Despite the majority of adolescents being seen every year in primary care, only a third of depressed teens are identified in the usual health visit without use of a screening tool. One in every twelve teens in rural New England at health visits screen at risk for depression or suicide. Evidence exists that a collaborative care system where teens are screened for depression, providers receive training and supports to assess teens, and office staff are trained to provide follow up and referral will lead to better outcomes. The US Preventive Services Task Force recommends this approach. However, most clinicians, especially in small rural practices, find it overwhelming to change usual care and lack resources to establish enhanced office care linked to mental health services. Linking clinicians through the practice research network has provided regional practices with the support to implement innovative changes to enhance patient care. Through AHRQ support the Dartmouth COOP Project and CECH Practice-Based Research Networks (PBRNs) will partner with Dartmouth Hitchcock and regional mental health key stakeholders to establish the structure to train clinicians and their office staff, enhance mental health counseling options, provide clinicians with adolescent psychiatric input, and support office changes to respond to teen depression. The Dartmouth COOP Project will provide the tools and staff to assist practices in quality improvement with the office and form an ongoing group of practices and stakeholders to sustain improvements in the delivery of primary care adolescent mental health services. PUBLIC HEALTH RELEVANCE: The proposed Teen Mental Health program addresses a major public health issue affecting youth. By ages 19-20 twenty-three percent (23%) of youth have had an episode of depression and suicide is nationally the 3rd leading cause of death for 15-24 year olds. Enhanced primary care screening and management can play an important role in prevention and early treatment.