Ensuring Children's Healthy Mental Development: Key Measurement Issues in Screening, Referral, and Follow-Up Care

States can use the Medicaid program to build their capacity to provide mental health services for young Medicaid-enrolled children. This technical report is designed to assist states in assessing the effectiveness of their efforts to do so. In particular, it presents practical guidance and options for states to build measures to evaluate, screen, refer, and treat children's social and emotional problems.

The Issue: Young children's healthy social and emotional development is essential to ensure their readiness for school, academic success, and overall well-being. Research has shown that children from low-income families are at particular risk of developing social or emotional problems. Early diagnosis can improve the effectiveness of treatment for such developmental delays. Yet, physicians often do not identify children with developmental problems or those at risk for developing such problems. Medicaid—which in 2003 covered one of four children and half of all low-income children—can do much to strengthen children's mental health services. States can use the Medicaid program to make sure that children with problems are identified and receive appropriate treatment by primary care providers or specialists. But to do so, state program administrators require valid and reliable measures to gauge the effectiveness of their efforts and make ongoing improvements.

Type of Innovation: Quality monitoring and improvement

Organization: National Academy for State Health Policy

Date of Implementation: April 2005

T arget Populations: State Medicaid administrators, young children (ages 0 to 3)

The Intervention: This technical report provides reliable and valid measures to inform efforts at state Medicaid agencies to strengthen young children's mental health services. In particular, the measures are designed to capture:

• the percent of children 0 to 3 who are screened to identify concerns related to their social and emotional development;
• the percent of children 0 to 3 who are referred for services to prevent or treat social and emotional problems; and
• the percent of children 0 to 3 who are treated for delays in social and emotional development, or treated to prevent those delays.

The measures are drawn from the experience of five states—California, Illinois, Iowa, Minnesota, and Utah—that are working with the National Academy for State Health Policy to strengthen children's mental health services. The project, known as the ABCD II consortium, is supported by The Commonwealth Fund. Although the measures were developed with the ABCD II consortium, they can be used by any state to implement, measure, and improve mental health services for young children. The report explores methods and issues for Medicaid administrators to consider as they develop and implement the three common measures. In particular, it discusses:

• assumptions about each measure and how it will be used;
• an overview of each measure, including questions that need to be clarified in order to implement it;
• possible data sources, including which sources are and are not recommended for the measure;
• methodological issues to consider;
• examples of measurement approaches; and
• implementation tips.

To read the technical report, download the attachment posted at right.

For More Information: Contact Neva Kaye, Child and Adolescent Health Measurement Initiative, at [email protected], or Colleen Peck Reuland, Child and Adolescent Health Measurement Initiative, at [email protected].