Comprehensive Essay on Children and Adolescents Mental Health Assessment and Intervention  

In the scenario of YMH Boston’s (2013) vignette, the mental health professional (MHP) is assessing a male adolescent who presents based on a referral from his general practitioner (GP) for concerns regarding anxiety and (Comprehensive Essay on Children and Adolescent Mental Health Assessment and Intervention).depression(Comprehensive Essay on Children and Adolescent Mental Health Assessment and Intervention). The patient presents alone, and the MHP inquires the patient as to whether he understands the reason for the referral (YMH Boston, 2013). This is an important assessment question because it helps the provider understand the manifestation of symptoms that lead to the referral (Srinath et al., 2019). Additionally, this allows the provider to assess some of the patient’s insight into his condition and gives a small glimpse at the patient’s attitude toward treatment. In this case, the patient is not oblivious to the referral rationale but does not seem to agree with the GP’s concerns (YMH Boston, 2013).   (Comprehensive Essay on Children and Adolescent Mental Health Assessment and Intervention).     

Although this assessment question provided significant information, the MHP dug into the assessment questions without any rapport-building conversation (YMH Boston, 2013)(Comprehensive Essay on Children and Adolescent Mental Health Assessment and Intervention).. Building rapport is essential in all healthcare settings, vital in all mental healthcare settings, and indispensable when handling the mental health of adolescents. The success of the interview in collecting accurate and complete information depends greatly on the level of trust that the patient has in the interviewer – meaning that building rapport increases the likelihood of getting truthful responses (Holly, 2020)(Comprehensive Essay on Children and Adolescent Mental Health Assessment and Intervention).. Adolescents report a fear of stigma as a substantial barrier to accessing mental health services, and the provider did not establish a judgment-free environment before asking sensitive questions such as whether the patient partakes in drug or alcohol use (Radez et al., 2021; YMH Boston, 2013). (Comprehensive Essay on Children and Adolescent Mental Health Assessment and Intervention).

Finally, adolescents also cite a lack of confidentiality as a reason for not seeking mental health treatment (Radez et al., 2021). The MHP should include an introduction of herself and the services offered prior to initiating the interview. This introduction should include the ways in which the patient’s privacy is protected and what information would be communicated under outlined circumstances and to whom the information would be divulged(Comprehensive Essay on Children and Adolescent Mental Health Assessment and Intervention)..        The interview reveals some concerns about the patient’s mental state (YMH Boston, 2013). The patient reports decreased energy to the point of struggling to get out of bed in the mornings and inability to participate in his favorite activities (YMH Boston, 2013). He also reports intense anger, passive suicidality, and thoughts of self-harm, although no further information about the harm-centered behaviors is revealed in the video (YMH Boston, 2013). Of utmost importance is the concern of self-harming thoughts combined with the passive suicidal statements of wishing he were not alive. At this point in the interview, a suicide risk assessment should be conducted, which can be done by utilizing a screening tool such as the Columbia Suicide Severity Rating Scale (appropriate for ages five and up and takes 30 minutes to complete) or the Ask Suicide Screening Questions Toolkit (proper for patient’s aged eight and older and takes only 20 seconds to administer the initial screening set) (Rural Health Information Hub, n.d.; Wisconsin Department of Public Instruction, n.d.). In this particular scenario, the next question that I would ask is whether the patient has a plan to act on the thoughts to determine how acute the situation is. To follow that question, I would assess the patient’s intention of acting on the thoughts/plans to provide a better picture of how prominent the suicide risk is.   (Comprehensive Essay on Children and Adolescent Mental Health Assessment and Intervention).   

 In a more general sense, collecting a thorough mental health assessment is the window into the patient’s overall health (mental and physical) and prognosis (Srinath et al., 2019). Half of all mental health disorders develop by age fourteen, according to the World Health Organization, although many of the conditions are undiagnosed for an extended period and continue to increase the individual’s risk of suicide (Holly, 2020). Additionally, developmental concerns, overlapping symptoms between mental health conditions, examiner bias, misleading information provided by caregivers, and disregard of alternative explanations for symptomatic behaviors make arriving at an accurate diagnosis for children and adolescents challenging (Merten et al., 2017). Obtaining a thorough assessment helps to paint a clear picture of the patient’s clinical condition and reduces the risk of misdiagnosis.(Comprehensive Essay on Children and Adolescent Mental Health Assessment and Intervention).      

 One difference between child/adolescent and adult mental health treatment/assessment is that parents provide a significant amount of historical information pertaining to the child and his/her development (Srinath et al., 2019). The chronological and developmental age of the child help denote the level of involvement parents have. Interviewing adolescents in private for at least part of the session is important; however, interviewing a toddler without the presence of a familiar adult may cause distress to the child, especially in the initial stages of therapy (Srinath et al., 2019). Another difference between adult and child/adolescent mental health treatment is that child-centered play therapy is a treatment option that is available to children that unavailable/inappropriate for adults (Pester et al., 2019). Another difference between the two divisions of mental health services is that the majority of children with mental health conditions are treated in specialized psychiatric settings while only adults with severe mental illness are managed by mental health specialists (Lamb & Murphy, 2018). This is in part because many GPs are unfamiliar and uncomfortable with assessing and treating psychiatric mental health conditions.

• References
• Holly, F. (2020, October). Assessing mental health in vulnerable adolescents. Nursing2022, 50(10), 48-53. https://doi.org/10.1097/01.NURSE.0000697168.39814.93  Lamb, C. & Murphy, M. (2018, January 2). The divide between child and adult mental health services: Points for debate. The British journal of psychiatry, 202(s54), 41-44. https://doi.org/10.1192/bjp.bp.112.119206  Merten, E. C., Cwik, J. C., Margraf, J., & Schneider, S. (2017, January 17). Overdiagnosis of mental disorders in children and adolescents (in developed countries). Child and adolescent psychiatry and mental health, 11(5). https://doi.org/10.1186/s13034-016-0140-5  O’Brien, D., Harvey, K., Howse, J., Reardon, T., & Creswell, C. (2016, October). Barriers to managing child and adolescent mental health problems: A systematic review of primary care practitioners’ perceptions. British journal of general practice, 66(51), e693-e707. https://doi.org/10.3399/bjgp16X687061  Pester, D., Lenz, S., Aquila, J. D. (2019). Meta-analysis of single-case evaluations of child-centered play therapy for treatment mental health symptoms. International journal of play therapy, 28(3), 144-156. (Comprehensive Essay on Children and Adolescent Mental Health Assessment and Intervention).http://dx.doi.org/10.1037/pla0000098  Radez, J., Reardon, T., Creswell, C., Lawrence, P. J., Evdoka-Burton, G., & Waite, P. (2021). Why do children and adolescents (not) seek and access professional help for their mental health problems? A systematic review of quantitative and qualitative studies. European child & adolescent psychiatry, 30, 183-211. https://doi.org/10.1007/s00787-019-01469-4  Rural Health Information Hub. (n.d.). Screening for and addressing suicide risk in clinical settings. Retrieved from (Comprehensive Essay on Children and Adolescent Mental Health Assessment and (Comprehensive Essay on Children and Adolescent Mental Health Assessment and Intervention).Intervention).https://www.ruralhealthinfo.org/toolkits/suicide/2/screening-tools  Srinath, S., Jacob, P., Sharma, E. & Gautam, A. (2019). Clinical practice guidelines for assessment of children and adolescents. Indian journal of psychiatry, 61(2), 158-175. http://doi.org/10.4103/psychiatry.IndianJPsychiatry_580_18  Wisconsin Department of Public Instruction. (n.d.). Behavioral health screening tools. Retrieved from https://dpi.wi.gov/sspw/mental-(Comprehensive Essay on Children and Adolescent Mental Health Assessment and Intervention).health/mental/behavioral-health-screening/behavioral-health-screening/tools  YMH Boston. (2013, May 22). Vignette 5 – Assessing for depression in a mental health appointment Links to an external site. [Video]. YouTube. https://www.youtube.com/watch?v=Gm3FLGxb2ZU (Comprehensive Essay on Children and Adolescent Mental Health Assessment and Intervention).

Comprehensive Essay on Children and Adolescent Mental Health Assessment and Intervention-Discussion Response

Thank you, Jessica, for highlighting the critical aspect of child/adolescent mental health assessment and intervention. Your approach to addressing issues includes the importance of the client’s insight on their condition or reason for visit, rapport building, comprehensive mental health assessment, suicide risk assessment, collateral information, and child/adolescent-specific interventions(Comprehensive Essay on Children and Adolescent Mental Health Assessment and Intervention).. I could agree less concerning the need to understand whether the client is aware of the reason for their visit, which is central to determining the client’s attention and orientation. Orientation is central in ascertaining the client’s cognitive abilities and providing crucial subjective information to guide assessment and intervention (Srinath et al., 2019). Moreover, rapport-building conversations are shown that the case scenario is central to establishing a therapeutic alliance, such as a positive relationship between the mental health personnel and the client (Hartley et al., 2020). Positive relationships are crucial to obtaining crucial and accurate information to aid diagnosis and intervention and client satisfaction with mental healthcare services.(Comprehensive Essay on Children and Adolescent Mental Health Assessment and Intervention).

Furthermore, I am glad you noted the need for suicide risk assessment when dealing with adolescents. Notably, statistics show that adolescents suffering from anxiety and depression have high risks of suicide (Brahmbhatt et al., 2019), and as mental health personnel, it is crucial to establish an evidence-based criterion for risk assessment(Comprehensive Essay on Children and Adolescent Mental Health Assessment and Intervention).. Risk assessment provides additional insight into the client’s manifestations and potentially risky behaviors for self and others. It is vital to identify collateral information when dealing with children and adolescents, considering the potential of their ability to provide meaningful information to aid diagnosis and intervention. Collateral history provides additional information besides that which is contained in the client’s self-report (Owoyemi et al., 2021). When dealing with children and adolescents, comprehensive mental health necessitates gathering information from clients, caregivers, family, and other close associates. Otherwise, a diagnostic interview should provide preliminary information equally crucial for definitive diagnosis and intervention.(Comprehensive Essay on Children and Adolescent Mental Health Assessment and Intervention).

References

Brahmbhatt, K., Kurtz, B. P., Afzal, K. I., Giles, L. L., Kowal, E. D., Johnson, K. P., … & Workgroup, P. (2019). Suicide risk screening in pediatric hospitals: clinical pathways to address a global health crisis. Psychosomatics, 60(1), 1-9. https://doi.org/10.1016/j.psym.2018.09.003(Comprehensive Essay on Children and Adolescent Mental Health Assessment and Intervention).

Hartley, S., Raphael, J., Lovell, K., & Berry, K. (2020). Effective nurse-patient relationships in mental health care: A systematic review of interventions to improve the therapeutic alliance. International Journal of Nursing Studies, 102, 103490. https://doi.org/10.1016%2Fj.ijnurstu.2019.103490(Comprehensive Essay on Children and Adolescent Mental Health Assessment and Intervention).

Owoyemi, P., Salcone, S., King, C., Kim, H. J., Ressler, K. J., & Vahia, I. V. (2021). Measuring and Quantifying Collateral Information in Psychiatry: Development and Preliminary Validation of the McLean Collateral Information and Clinical Actionability Scale. JMIR Mental Health, 8(4), e25050. https://doi.org/10.2196%2F25050(Comprehensive Essay on Children and Adolescent Mental Health Assessment and Intervention).

Srinath, S., Jacob, P., Sharma, E., & Gautam, A. (2019). Clinical practice guidelines for assessment of children and adolescents. Indian Journal of Psychiatry, 61(Suppl 2), 158. https://doi.org/10.4103%2Fpsychiatry.IndianJPsychiatry_580_18(Comprehensive Essay on Children and Adolescent Mental Health Assessment and Intervention).