Accurate assessment and identification of youth mental health difficulties is essential for optimal clinical care. Without proper assessment, mental health conditions can be misdiagnosed or even overlooked, leading to increased suffering, a need for longer and more intensive treatments, increased emergency services and hospitalizations, and even the loss of life to suicide. Measurement-based care (MBC) is a clinical process where behavioral health clinicians use evidence-based, patient-reported, outcome measure data to accurately identify difficulties, track progress, and inform treatment decisions. With the support of U.S. Congressman Gerry Connolly who championed this project, the Center for Evidence-Based Behavioral Health (CEBBH) at George Mason University will achieve the following two aims with regional partners: train clinicians who serve diverse, low-income youth and families, and their clinical supervisors, in the use of MBC to allow for regular administration of culturally sensitive evidence-based assessments to clients; and help administrators effectively implement use of MBC across their organizations so that all clients may benefit from their use. We will train 150 clinicians and 40 clinical supervisors who serve youth and families within our five Northern VA Region 2 Community Services Boards (CSBs; state-funded community mental health centers that serve the uninsured, under-insured, and Medicaid populations) located in Fairfax-Falls Church, Prince William, Alexandria, Arlington, and Loudoun Counties. Across these CSBs, thousands of youth are seen annually for mental health (e.g., suicidality, depression, anxiety, conduct problems, trauma, etc.) and substance abuse difficulties. Further, the catchment area for these CSBs is diverse. According to US Census Bureau data, across the public school systems in Region 2, students are 48-50% male, 39-59% White, 7-21% Black/African American, 6-22% Asian, 0-1% other, 4-6% two or more races, and 14-25% are Hispanic. Approximately, 3-16% of youth under the age of 18 live below the poverty line.
Over the course of this one-year project, our broad goals are to develop, pilot, and implement a measurement-based care system, integrated into electronic health records, within each of the Region 2 CSBs. To ensure the success of these efforts and fit to the clientele and CSBs served, this work will be guided by interviews and surveys with the clinicians who serve these diverse low-income youth and families, clinical supervisors, organizational administrators, and youth and families seeking services. By the end of our project, our primary objectives are to train 90-100% of clinicians and clinical supervisors across CSBs in use of the MBC system, and for clinicians to use MBC to guide treatment planning with at least 80% of their youth caseload. This project holds the potential to improve the quality of care for youth seeking services within the Region 2 CSBs, decrease treatment length, decrease costs of care for families, and save young lives. Our focus on culturally sensitive assessment will also contribute to decreases in disparities in access to high quality behavioral healthcare for our most diverse and lowest income youth and families seen in the Region 2 CSBs.