Iterative and comprehensive mental health assessment and treatment planning: the mental health dashboard

Background: There is growing recognition of the prevalence of mental health disorders in children, and of the importance for recognition and selective prevention in the pediatric setting. Pediatric Primary Care Clinicians (PPCCs) need a tool to capture their observations, weigh risks against strengths, identify problems, and develop intervention plans, particularly when specialty mental health consultation is lacking or when referral for mental health treatment is difficult. Methods: A Mental Health Dashboard is described as an innovative clinical tool to organize information about the mental health of children. This tool considers the child’s life situation and clinical manifestations, organized in eight domains, and considering the child’s developmental level. The tool allows identifying symptom patterns of concern, as well as child and family strengths, and guiding intervention planning. Screening tools may augment and anchor the findings. Results: Case vignettes for a pre-school child with trauma, a school-age child with learning disability and symptoms of ADHD, and an adolescent with mood symptoms and substance use illustrate use of the Dashboard. Conclusions: Primary Care Clinicians, who know the patient and family, are positioned to identify emerging symptoms as well as family strengths, and to mobilize community resources for intervention planning when the option of specialty mental health referral is not indicated or is unavailable. The Mental Health Dashboard arrays observations and organizes an intervention plan.