The Development of a Brief but Comprehensive Therapeutic Assessment Protocol for the Screening and Support of Youth in the Community to Address the Youth Mental Health Crisis

Margaret Danielle Weiss; Eleanor Castine Richards; Danta Bien-Aime; Taylor Witkowski; Peyton Williams; Katie E Holmes; Dharma E Cortes; Miriam C Tepper; Philip S Wang; Rajendra Aldis; Nicholas Carson; Benjamin Le Cook

doi:10.3390/brainsci14111134

The Development of a Brief but Comprehensive Therapeutic Assessment Protocol for the Screening and Support of Youth in the Community to Address the Youth Mental Health Crisis

Brain Sci. 2024 Nov 10;14(11):1134. doi: 10.3390/brainsci14111134.

Authors

Margaret Danielle Weiss^{1

2}, Eleanor Castine Richards^{1

2}, Danta Bien-Aime¹, Taylor Witkowski¹, Peyton Williams¹, Katie E Holmes¹, Dharma E Cortes^{1

2}, Miriam C Tepper^{3

4}, Philip S Wang^{5

6}, Rajendra Aldis^{1

2}, Nicholas Carson^{1

2}, Benjamin Le Cook^{1

2}

Affiliations

¹ Cambridge Health Alliance, 1493 Cambridge St., Cambridge, MA 02139, USA.
² Department of Psychiatry, Harvard Medical School, Boston, MA 02215, USA.
³ Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY 10032, USA.
⁴ New York State Psychiatric Institute, New York, NY 10032, USA.
⁵ Center for Learning Health Systems, Brigham and Women's Hospital, Boston, MA 02115, USA.
⁶ Department of Psychiatry, Harvard University, Boston, MA 02115, USA.

Abstract

Objective: The objective of this study was to explore the acceptability and feasibility of a therapeutic assessment protocol for the Screening and Support of Youth (SASY). SASY provides brief but comprehensive community-based screening and support for diverse youth in the community.

Methods: SASY screening evaluates symptoms, functioning and clinical risk. The Kiddie Computerized Adaptive Test was used to evaluate seven different diagnoses and symptom severity. The Weiss Functional Impairment Rating Scale-Self was used to measure functional impairment. Measures were scored according to nationally developed norms. An algorithm was developed to aggregate symptom and function ratings into an overall score for clinical risk. The results are discussed with participants in a motivational interview designed to promote insight, followed by the opportunity for the participant to engage in an online intervention. Protocol changes necessitated by social distancing during the pandemic led to innovative methods including the use of a QR code for recruitment, integration of both online and offline participation, and expansion from in-person recruitment within the schools to virtual engagement with youth throughout the community. The final sample included disproportionately more Black or African American and Hispanic youth as compared to school and community statistics, suggesting that optimization of online and offline methods in research may facilitate the recruitment of diverse populations. Qualitative interviews indicated that the screening and feedback raised youth awareness of their wellbeing and/or distress, its impact on their functioning, and engagement with options for improved wellbeing.

Conclusions: The emergence of innovative methods optimizing the advantages of both online and offline methods, developed as a necessity during the pandemic, proved advantageous to the feasibility and acceptability of community-based recruitment of at-risk, minoritized youth.

Keywords: access to treatment; health equity; pandemic; virtual research; youth mental health.

Grants and funding

1P50MH654321-21P50/NH/NIH HHS/United States