the availability of an intervention when a risk has been identified. Multiple approaches are available, but few have been tested in conjunction with screening in real-world environments.
Recommendation 8-1: Research funders should support a rigorous research agenda to develop and test community-based partnership models involving systems such as education (including preschool), primary care, and behavioral health to screen for risks and early mental, emotional, and behavioral problems and assess implementation of evidence-based preventive responses to identified needs.
The effectiveness of screening in primary care and emergency departments could be improved if mental health and substance abuse professional organizations were to work with the various professional organizations, such as the American Academy of Pediatrics, the National Association of Pediatric Nurse Practitioners, and the emergency physicians’ groups, to develop a consensus on the best instruments for screening for specific behavioral health issues. Policy makers, providers, advocates, and researchers could then provide technical assistance to ensure the use of these tools and evaluate their impact on screening children for behavioral health issues (Semansky et al., 2003). Many of these screening tools are designed to elicit information from parents rather than through clinician observation, requiring minimal staff time to administer. Literacy and language competence must be addressed when using this approach.
Similarly, screening and preventive interventions are more likely to be acceptable and used in a community if members of the community, including parents, are involved in the design of these approaches (see also Chapter 11). Parental involvement in identification of risk, selection of screening tools, and development of follow-up protocols may help address concerns about stigma and labeling. Similarly, involvement by a range of community providers can help ensure that resources are targeted to identified community needs.
There is clear evidence that certain groups of young people face an increased likelihood of negative mental, emotional, and behavioral developmental outcomes. As a result, interventions aimed at assessing and treating these young people have been put in place. Opportunities also exist to provide preventive interventions for groups at known risk.
Conclusion: Some groups of young people, such as children in foster care, children in juvenile detention facilities, and children of depressed parents, are known to have a greatly elevated risk for MEB disorders. Targeted screening or in some cases full assessment of individuals in