PROBLEM
It is estimated that four million children and adolescents are affected by a mental health problem or psychosocial morbidity (e.g., depression, substance abuse, disordered eating) (U.S. Surgeon General, 1999). As a result of the recent national tragedy, war, and threats of bioterrorism, this percentage may escalate further. Although the majority of morbidities affecting children and teens in this new millennium are emotional and behavioral problems as well as injuries, there is a paucity of mental healthcare providers in the healthcare system to address the mental health needs of children and adolescents. In fact, approximately 70 percent of children with mental health disorders do not receive needed treatment (U.S. Surgeon General).
Because of these growing problems, the Project Director for this application recently founded a new national campaign through the National Association of Pediatric Nurse Practitioners (NAPNAP) entitled KySS (Keep your children/yourself Safe and Secure) (Melnyk et al., 2001). Currently a collaboration of 17 national nursing and interdisciplinary organizations, the mission of the KySS campaign is to prevent and reduce mental health/psychosocial morbidities and to enhance safety in children and adolescents. Preliminary data from nurse practitioners and physicians responding to a national KySS survey that was recently completed and published (Melnyk et al., 2002) indicate that the majority of these providers do not feel comfortable or adequately prepared to assess and treat common emotional and behavioral disorders in children and adolescents. However, primary care providers who do not have adequate mental health training are often faced with evaluating and treating mental health disorders in children and youth (U.S. Surgeon General, 1999).
GOALS & OBJECTIVES
The goals of the proposed program, congruent with Healthy People 2010 objectives and all three MCHB goals, are to: (a) develop and implement a strategic plan to improve the mental health outcomes and safety of children and adolescents, and
(b) enhance the knowledge and skills of nurse practitioners, nurses, and physicians who care for children and adolescents in the areas of assessment, early intervention, and prevention of pediatric mental health/psychosocial morbidities. The objectives of this program are to:
1. Develop and implement a KySS strategic plan to prevent and reduce mental health/psychosocial morbidities as well as injuries in pediatric primary care practices.
2. Develop a KySS core curriculum that will serve as a guide for providing essential content on mental health morbidities in nurse practitioner and medical school/pediatric residency curriculums.
3. Increase the number of nurse practitioners, nurses, and physicians in primary care settings who have the knowledge and skills to assess and provide early interventions with children and teens who have mental health/psychosocial morbidities through conducting a KySS continuing education (CE) certificate program.
4. Increase the number of nurse practitioners and physicians in primary care settings who use evidence-based practice strategies and the new Bright Futures in Practice: Mental Health to promote the mental health and safety of children and adolescents.
5. Offer the KySS Certificate Program on CD-ROM in order to reach nurse practitioners, nurses, and physicians nationally as well as to provide outreach to those providers in underserved/rural areas.
6. Conduct an outcomes evaluation to determine the impact of the KySS certificate program
and strategic plan in preparing healthcare providers who can more effectively meet the bio-psycho-social needs of children and youth and their families.
METHODOLOGY
In Year 1 of this grant, a KySS summit will be held with multidisciplinary
professionals who have expertise in pediatric mental health/psychosocial morbidities to develop a strategic action plan for preventing and reducing mental health morbidities as well as injuries in children and adolescents. In this summit, strategies to enhance primary care providers’ ability to assess and provide early interventions with children and teens who have mental health/psycho-social problems will be developed. In addition, content for a 3-day KySS continuing education (CE) certificate program will be planned and a core curriculum on mental health/psychosocial morbidities in children and teens will be developed for nurse practitioner and physician curriculums in order to standardize content of programs to produce graduates who are competent in assessing and providing early interventions to children and teens with these problems in primary care practices as well as competent in implementing primary care prevention strategies.
In Year 2, a 3-day KySS CE program will be held. Content will include: (a) factors that place children and teens at high-risk for mental health problems as well as factors/developmental assets that protect them from mental health problems, (b) assessment and early management of the most common mental health/psychosocial morbidities and injuries in children and teens, and (c) preventive interventions for primary care practice. The KySS CE program will be taped so that it can be placed on CD-ROM in order to aggressively disseminate the program nationally to nurse practitioners, nurses, and physicians in Years 2 and 3.
COORDINATION
Dr. Bernadette Melnyk (Project Director), Dr. Dolores Jones (Director of Professional Affairs for NAPNAP and Co-Director for this Project), and Dr. Julie Novak (current president of NAPNAP and Co-Director for this Project) will assume primary responsibility for coordinating all phases of this project in collaboration with Dr. Richard Kreipe (Director of the Rochester LEAH program), Dr. Andrew Doniger (Director of the Monroe County Health Department), Dr. Michael Weitzman from the American Academy of Pediatrics’ Child Health Institute, and the KySS campaign’s assistant directors.
EVALUATION
Outcomes of the KySS summit will include: (a) a written KySS strategic action plan and core curriculum that will be disseminated through all 23 KySS collaborating partners as well as to graduate nurse practitioner programs and medical schools/pediatric residency programs, and (b) content, objectives, and speakers for the KySS CE workshop. The quality of the KySS CE program also will be evaluated along with its impact on the practice of nurse practitioners, nurses, and physicians who complete it.
ANNOTATION
The goals of this project are to: (a) develop and implement a strategic plan to improve the mental health outcomes and safety of children and adolescents, and (b) enhance the knowledge and skills of nurse practitioners, nurses, and physicians in the assessment, early intervention, and prevention of pediatric and adolescent mental health/psychosocial morbidities and injuries. These goals will be accomplished through an interdisciplinary summit and CE certificate program. Dissemination of the CE program on CD-ROM will allow outreach to nurse practitioners, nurses, and physicians nationally.
KEYWORDS
mental health; health promotion; adolescents; preventive health care, professional education in behavioral pediatrics; professional education in psychological evaluation; pediatric nurse practitioners; pediatricians; professional education in primary care
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