Book Summary: This book is really a reflection of the past more than 20 years of work with teens and suicide prevention in the state of Kentucky. The work to establish the “Stop Youth Suicide Campaign (SYS)” has resulted in contact with many young adults, and we have found that the most important thing for all of them was finding a caring person they trust and can talk to. Because of the constant need, the SYS went from a goal of being a one year awareness campaign to becoming a major community resource, working with the state and local governments and state legislators to add as many resources as possible. We have witnessed for the first time a drop of youth suicide rates below the national average, according to the 2013 Youth Risk Behavior Surveillance done biannually by the Center for Disease Control. In this book, we will tackle various topics and specific populations in relation to suicide written by people who work with teens and care about them.

No description available.

The integration of primary care and mental health care is a requirement of the Patient Protection and Affordable Care Act of 2010 and has challenged primary care providers to address gaps in the quality of care provided for patients with mental health issues. Vulnerable populations, such as the American Indian people experience gaps in quality health care, especially communication gaps and language barriers. This quality improvement project used a survey design to explore the potential for primary care providers to adopt a culturally sensitive electronic mental health, screening tool to bridge communication gaps and language barriers. Primary care providers recruited from the Northern Arizona University (NAU) Campus Health Services clinic evaluated the concept of a touch screen iPad technology to implement the Patient Health Questionnaire-9 (PHQ-9), which screens for depression using audio options in English and in the Navajo language to accommodate American Indian patients. A PowerPoint overview of the iPad technology was sent via email to the NAU providers and included; the PHQ-9 screening results, which are to be immediately accessible in the patient's electronic health record along with a screening report. The screening report included the PHQ-9 depression score, interpretation of the score, best treatment choices, and a graph for monitoring patient progress. This survey results concluded providers perceive the iPad technology for mental health screening to be useful in their integrated primary care clinic. A modified Technology Acceptance Model (Davis, 1989) was used to evaluate the providers' perception of the iPad Technology, and the University of Arizona's Qualtrics survey system provided data analysis of the survey results.

The pediatric primary care setting has been discussed as playing a central role for the identification and treatment of behavioral and mental health disorders in youth. Although this setting is in a unique position to provide these services, there are many barriers to the integration of mental health care and pediatric primary care. The aim of this study is to examine perspectives of multiple stakeholders (i.e., patient, parent, nurse, resident, faculty, clinic director) in a pediatric primary care setting to explore barriers, behavioral and mental health needs, and facilitators to the integration and provision of mental health care for children and families in pediatric primary care. The study involved both focus group and individual interviews with a total of 36 stakeholders (patient n = 2; parent n = 7; nurse n = 4; resident n = 16; faculty n = 5; clinic director n = 2). A grounded theory approach was used to analyze the focus group and interview data. Barriers to integration and consequences of these barriers are presented, as well as facilitators identified by stakeholders to overcome these obstacles. Identified behavioral and mental health needs will also be presented. Limitations of the study and future directions are discussed.

Integrated primary care (IPC) may help palliate the demand for mental health services and barriers to such care. There are varying degrees of integration (Blount, 2003; Doherty, 1995; Strosahl, 1998), with suppositions that certain patients may fare better in certain levels/models of IPC than in others (Doherty, McDaniel, & Baird, 1996; Mauer, 2006). No research to date has examined the interface between levels of care and patient behavioral and physical health demands, hence the aim of the current study. The current study utilized Mauer’s (2006) Four Quadrant Model to ascertain patient differences in behavioral and physical health demands and utilization across three levels of care: co-located, integrated, and a hybrid (receipt of both colocated and integrated care) for a general adult population within a community-based nurse practitioner-led FQHC. Total time spent in behavioral health treatment, total number of behavioral health sessions, number of presenting behavioral health concerns at baseline, and number of behavioral health no-shows and cancellations since baseline, differed significantly across the levels of integration. Number of past-year medical visits, number of chronic illnesses, and number of active medications at baseline did not differ significantly between groups, indicating that patient differences between levels of care were based more on behavioral health variations than physical variables. Moreover, patients were no more or less likely to be represented in one level/model of care over another based on patient quadrants, or combinations of high and low physical and behavioral health demands. This study is the first to our knowledge to examine the intersect of patient quadrants and levels/models of IPC. Future research should examine the intersect and impact of level/model of care and patient behavioral and physical health demands on outcome.

No description available.

No description available.

No description available.

Many barriers have been proposed to explain why rural residents do not receive adequate behavioral health services even though the need for such services is great. One solution proposed to address the need in rural settings is to offer these services within primary care. This study was designed to examine child attendance rates at integrated behavioral health clinics (BHCs) in rural primary care offices. Referral forms for all children recommended to attend three BHCs were reviewed by research assistants. Attendance at appointment, length of time on waiting list, severity of the problem, referral reasons, and parent stress were coded. Across the three BHCs, nearly 88% of children referred were scheduled for an initial appointment, and 81% of children referred for behavioral health services attended the initial appointment. Follow through for children referred by their primary care physician to a colocated behavioral health specialist in rural settings was much higher than found in other studies. These data suggest that in rural settings integrated care may increase access to and continuity of care for a population that is often neglected.

No description available.