Screening

Screening for social, emotional and developmental concerns is essential to early identification of mental health problems in children and youth. It is the first step to discovering when a child may need further diagnosis and treatment. Screening provides an opportunity to intervene early and improve the course of healthy development and functioning.

Screenings usually occur in places accessible and appropriate to the needs of children and youth. These settings include primary health care, home visiting, Head Start and early childhood education. The process also provides families with information about early childhood development and appropriate services and supports.

The Minnesota Interagency Developmental Screening Task Force provides recommendations for developmental and social-emotional screening tools for young children. Refer to the All Instruments at a Glance document for these recommendations.

In addition to developmental and social-emotional screening for young children, there are other screening initiatives and instruments that target certain ages or circumstances related to the mental health of children and youth.

Child and Teen Checkups (C&TC)

Child & Teen Checkups (C&TC) provides comprehensive age-related preventive health checkups to children, age birth to 21, enrolled in Medicaid. These screenings ask questions about common issues in children’s and teens’ lives and can discover developmental or mental health concerns that then allow them to access services. Earlier identification means earlier intervention to treat depression or other conditions, preventing problems from becoming more severe and saving lives. Developmental and social-emotional screening is strongly recommended for these children and beginning at age 12 a mental health screening is a requirement during a C&TC visit, as outlined in the C&TC Schedule of Age-Related Screening Standards.

For social-emotional screening in children 0 through 5 years of age, refer to the Recommended Social-Emotional Screening Instruments for young children.

For information on mental health screening in children 6 to 21 years of age, refer to the Detailed Comparison Table of Approved Mental Health Screening Instruments.
Child welfare
DHS implements requirements in 2003 legislation to integrate mental health screening into child welfare practices for children and youth (3 months to 18 years) receiving child protective services or in out-of-home placement. This intent of this integration is to identify and respond sooner to children and youth with mental health problems as well as decrease the need for child welfare services.

DHS works with county child welfare systems to ensure all children with substantiated abuse receive mental health screening and appropriate assessments and treatments. This screening encourages collaboration among parents and systems serving children to reach better outcomes.

DHS approved the following tools for mental health screening of children and youth in the child welfare system:
- Ages & Stages Questionnaire: Social-Emotional, Second Edition (ASQ:SE-2)
- Pediatric Symptom Checklist (PSC)
Head Start

Federal Performance Standards require Head Start programs to develop systems for screening, identifying and treating children with emotional difficulties. This federal mandate also requires Head Start to contract with mental health professionals to offer consultation services for students with social or emotional problems. In recent years, the Minnesota Head Start Association (MHSA) has been aware of this mandate as well as increased levels of mental health needs among the children Head Start serves. The MHSA follows the Minnesota Interagency Developmental Screening Task Force’s screening recommendations for Head Start and Early Head Start.
Juvenile justice
Seventy percent of youth involved with juvenile corrections have mental health disorders. DHS partners with other state and local agencies to improve outcomes for these youth, ages 10 to 18 years. The 2003 Legislature amended the Minnesota Juvenile Code to require mental health screening for juvenile justice populations.

DHS approved the following tools for mental health screening of youth in the juvenile justice system:
- Massachusetts Youth Screening Instrument Version 2 (MAYSI-2)
- Problem-Oriented Screening Instrument for Teenagers (POSIT)
Maternal depression

As early as one month old, an infant can sense whether or not a parent is depressed or angry and is affected by the parent’s mood. Children of depressed mothers are more likely than other children to have behavior, cognitive, socio-emotional and health problems. Untreated maternal depression can have major, lasting negative effects for the mother and her child.

Early detection and treatment of maternal depression can greatly reduce adverse consequences. There is an effort to make screening for material depression available as part of pediatric visits since a pediatric provider may be the only health provider a mother sees during the first year after delivery. Pediatric providers have the opportunity to identify symptoms of depression and refer mothers through routine screening at children’s Child and Teen Checkups (C&TC) or other pediatric visits.
Schools

Early Childhood Screening is a short, simple check of how children are doing and detects possible learning or health concerns so that children can get needed help before starting school. Minnesota state law requires this screening at least once between age three and prior to kindergarten. The target age for Early Childhood Screening is between three and four years of age, in order to allow time for any free services that may help a child to be ready for kindergarten. Parents may contact their local school district to schedule an Early Childhood Screening. A parent may also submit a copy of a comparable screen completed by Head Start, public health or a clinic to their district.