Friday, September 5, 2008

Labor Day is Over: Time to Get Back to the Blog

I think that this is the longest gap in this blog since I started back in December;  a little vacation, a bunch of school physicals, abstract writing for the Pediatric Academic Societies meeting and close observation of the political conventions seem to have interfered with my muse.  Also, I have been reluctant to begin a close reading of the final product of Yolanda's bill-  I know that we got a lot done, but I fear that I will become obsessed with the things that we didn't get done.  So, in resuming my writings, I thought that I would start by revisiting an old topic:  mental health screening.
I have a bit of information on the results of screening 12-18 year old children in our practice in Webster.  We are having each kid fill out the Y-PSC, and asking the CRAFFT questions verbally at each annual physical examination.  (We're collecting information on 12-18 year olds as part of our DPH contract for care coordination)  Last month, I told you about the results for July (here).  Now, I have the data for the first 9 months of 2008.
We have 1211 adolescent patients currently in our practice (as best we can tell).  We've managed to get about 40% of them in for physicals this year so far.  Here is the data:
Well visits done: 489 unique teens
Y-PSCs done: 482 (98 %)
CRAFFT done: 474 (97 %)
The screenings missed were usually because of lack of time or inability to separate parent and child (I don't usually ask the CRAFFT with the parent in the room).

Positive Y-PSC: 49 (10 %)
All were either already in treatment or referred for evaluation.  Many of the referrals didn't happen, for a variety of reasons already mentioned in this blog.
Positive CRAFFT:  17 ( 4%)
Most denied that they had a problem and only 40 % accepted referral for further evaluation.

Oh, and we should point out that only about 15% of our adolescent patients are on MassHealth.
Our practice seems to have integrated screening into the routine without too much disruption.  Patients and families have accepted the screens for the most part without incident.    It seems to have increased our rate of referral a bit, and our teens don't like to be referred for the treatment of substance abuse issues.
Do others have similar information?  Are we typical?  Post your comments on the blog.

FEEDJIT Live Traffic Map