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H H S Department of Health and Human Services
Health Resources and Services Administration
Maternal and Child Health

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Mental Health and EPSDT: Screening

Resources on Mental Health Screening for Children in Primary Care Settings

Standardized and Objective Screening Tools

Screening tools are designed to identify the likelihood that a mental or substance use disorder is present. They are not intended to result in a diagnosis nor provide the basis for a treatment plan, but they have been demonstrated to identify from 60 percent to 80 percent of children with MH problems.  A screening tool has:

  • A systematic, structured format including questions or statements (items) to which the respondent rates his or her response;
  • Directions on the tools’ use or scoring and indications of what scoring means; and 
  • Psychometric properties that are known through testing on relevant populations.

To be practical in primary care settings and used in EPSDT/well-child visits, a screening tool must be brief enough to fit into the short visit, be in a format that is practical to administer, and be affordable. An increasing number of States are recommending one to three objective developmental screening tools to encourage their use by primary care providers in EPSDT/well-child visits.

After Screening, What Next?

States can use Medicaid, Title V, and Mental Health and Substance Abuse agency resources in a number of ways to assist primary care physicians to find resources for assessment and treatment of families whose children have a positive screen:  

  • Provide effective outreach and informing to families
  • Facilitate or encourage co-location of behavioral health clinicians in primary care settings, whether private practice offices or federally qualified health centers
  • Authorize financing for parent-child “family” therapy when social emotional problems are identified in children under age five
  • Develop programs to provide timely psychiatric consultation to primary care providers (e.g., networks of consultants, telemedicine consults)
  • Increase provider participation in Medicaid and EPSDT
  • Use case management and care coordination resources to facilitate referrals
  • Clarify confidentiality requirements on sharing information between primary and behavioral health care
  • Develop forms to facilitate sharing between primary and specialty care