Showing posts with label Behavioral/Mental Health. Show all posts
Showing posts with label Behavioral/Mental Health. Show all posts

Thursday, October 17, 2013

Trauma Services for Children & Families: Lessons Learned from Program Evaluation

By Molly Ryan, MPH

This month several Institute for Community Health staffers will showcase our program evaluation work at the American Evaluation Association Annual Conference. Participatory program evaluation is central to the ICH mission and is one of our core services.  In honor of AEA and National Depression Screening Day, we’re highlighting our work evaluating mental health services with the Central Massachusetts Child Trauma Center (CMCTC).

ICH has partnered with CMCTC for the past year to evaluate their delivery of evidence-based, trauma-informed mental health services for children and adolescents, particularly those with a military affiliation. ICH and CMCTC project staff utilize standardized trauma evaluation tools to measure trauma exposures and symptoms, resulting behaviors, and caregiver strain. Mental health providers administer the tools, which are then sent to ICH for immediate analysis. This immediate analysis provides mental health clinicians, patients, and families with data in “real time”, allowing providers to efficiently modify the care plan and help validate patients and families’ experiences of trauma. Our periodic aggregate review of clinical assessment data also helps the project directors understand the strengths and limitations of the treatments, informs training improvements, and ultimately contributes to the treatment models’ evidence base.

As we enter our second year of evaluation, we’re reflecting on some of the key lessons learned:

Training
  • Just because a tool is standardized does not mean it’s easy to follow! In order to ensure data reliability, it’s important for providers to be trained users of the tools and for them to help clients complete the tools.
  • Evaluators must ensure that clinicians are comfortable using the evaluation tools in the clinical encounter.
    • Tip: Use a combination of text and graphics to explain evaluation results. This will help both providers and caregivers understand the data.


  • When using multiple data collection tools at multiple time points, help providers keep track of upcoming due dates. This is particularly important if providers have several clients enrolled in the evaluation.
    • Tip: Remind providers when a client’s follow-up assessment is approaching. Time the reminder so that clinicians have enough scheduling flexibility to complete the assessment.  Several reminders may also be necessary.
    • Tip: Create schematics like the one below to help providers understand when to complete evaluation tools.


Retention
  • It’s important to recognize that it can be difficult for vulnerable populations, such as individuals receiving trauma services, to remain in care. Unstable living situations, acute mental health problems, and readiness for treatment are just a few of the issues that our program population frequently endure. As a result, “lost to follow up” is a common issue for program evaluation.
    • Tip: Maintain open lines of communication with providers in order to track clients’ progress and create a tracking mechanism to document clients’ change in status.
    • Tip: Anticipate that clients are more likely to drop out of treatment in the first 3 months. Work with program staff to identify the information that is essential and meaningful to capture if a client has not been actively engaged in treatment.

Meaningful evaluation of mental health services depends on effective and efficient collaboration between project leaders, clinicians, and evaluators.  Our experience with this evaluation highlights the value of multi-disciplinary partnerships to improve mental health outcomes for children and their families. 

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The views expressed on the Institute for Community Health blog page are solely those of the blog post author(s), and do not necessarily reflect the views of ICH, the author’s employer or other organizations with which the author is associated.


Wednesday, September 18, 2013

On the Road with the Photovoice Show: An Intern’s Reflections


By Alice Chan, ICH Summer Intern

Tufts University Psychology Student Class of 2015


How do a crossword puzzle, a tennis racket, and food relate to mental health? According to eight Asian American teens, these items symbolize what they perceive to be the strongest influences on mental health and well-being: self care, the social environment, and family. For one teen, something seemingly as mundane as a tennis racket is significant for mental health: “tennis is a huge stress reliever for the workload I get from school.”

From January to April 2013, these eight teens developed their perspective, or “voice,” on mental health and wellness using Photovoice, a participatory visual method that utilizes photography to promote social change.  Developed by Caroline C. Wang and Mary Anne Burris in 1994, the Photovoice initiative helps youth explore and expand their understanding of a social issue through story-telling and photography (PhotoVoice, 2013). With support from Institute for Community Health’s (ICH’s) Dr. Shalini Tendulkar, the Chinese Culture Connection (CCC), and the Asian American Civic Association (AACA) - eight Malden teens used Photovoice to search within their communities and themselves to answer the following: “As an Asian American teenager, I think mental wellness is…”   

The results of their hard work—24 vibrant images and detailed reflections—were recognized state-wide. In April, The Families for Depression Awareness, a national non-profit organization, awarded the youth and the project partners the 2013 Distinguished Service in Mental Health Advocacy Award. Following this honor, the teens’ photos were presented in a series of public exhibitions, ranging from the 4th Annual Asian Pacific Islander Mental Health Forum to a special showcase at Malden City Hall. For the teens, most of whom are Malden residents, the opportunity to connect with their community through photography was ineffably meaningful:

“Photovoice made me think more about my own mental health, and the ways I could improve it. There are many factors that can badly influence our mental health, and with a different mindset we can change the way we live starting with our daily routines and experiencing new settings.”

All together, the photos held powerful messages reflecting what mental health and wellness mean to these teens as Asian Americans growing up in 2013.
As an undergraduate intern at ICH and an Asian American, I was amazed by the depth of the teens’ introspections on mental health in their diverse photos and original writings. At the end of this yearlong project, the teens invited the world to see mental health through their eyes, and academics, city officials, and community members alike were deeply touched by their stories.  It is clear that this traveling photo show made true lasting impressions on the community members of Malden and Boston, the project personnel, and me. I am so proud to have been involved with this project with Dr. Tendulkar, CCC, AACA, and, most importantly, our youth. What an incredible and unforgettable experience!
Learn about the ICH Internship Program
  

PhotoVoice. "Background to the Field: PhotoVoice, Photovoice Methodology and Participatory Photography." PhotoVoice, 2013. Web. 27 Aug. 2013. <http://www.photovoice.org/whatwedo/info/background-to-the-field>. 

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 The views expressed on the Institute for Community Health blog page are solely those of the blog post author(s), and do not necessarily reflect the views of ICH, the author’s employer or other organizations with which the author is associated.