Implementing the DSM-5 parent/guardian-rated level 1 cross-cutting symptom measure child 6−17 in a community mental health clinic

Problem

Despite their relevance to assessment and clinical decision-making in behavioral health, measurement tools are still rarely used in clinical settings. With an increase in undiagnosed and untreated mental health problems in children and adolescents, a southeastern US Community Health System was the ideal setting for the implementation of a behavioral health assessment tool.

Methods

This quality improvement project was conducted to address the question: “Among mental health clinicians at the Community Health System, will the use of the DSM-5 parent/guardian-rated level 1 cross-cutting symptom measure 6−17 (CCSM) improve diagnosis and treatment choices of children with mental health conditions, over a 4-week period?” A convenience sample was recruited from among behavioral health counselors working at various out-patient clinics and school-based counseling sites in the Community Health System. After nurse-led training on use of the CCSM, including a PowerPoint intervention and individual coaching sessions, the five clinical participants were encouraged to use the CCSM screening tool on their patients presenting for mental health assessment. Knowledge of the tool was assessed using a pre- and post-training survey. Completed screening tools were collected from participants over the 4-week duration of the project.

Findings

A chart audit comparing the project period with the previous year showed an increase in diagnosis and treatment in 6−17 year-old patients at the outpatient clinic.

Conclusions

This project demonstrated the usefulness of the CCSM for behavioral health assessment in the child/adolescent population at the Community Health System and supported use of the intervention in other clinics.