In the past few months, you’ve probably seen a lot of patients for back-to-school and back-to-sports check-ups. These visits may be the only time you see these patients in a year, so you’ve done what you can, given the time constraints, to assess mental as well as physical health. If you’ve taken our training Patient-Centered Mental Health in Pediatric Primary Care, you rely on validated screening instruments to give you a quick but accurate assessment.
But can you administer those tools to all of your patients and, as appropriate, their parents or guardians? If you have a multicultural patient base, you need self-report tools in the languages of the communities you serve. The good news is that some of the most widely used screening tools have been translated into many languages.
Two such tools are the Strengths and Difficulties Questionnaire and CRAFFT substance use questionnaire. Both have been validated for use with the recommended age groups.
The Strengths and Difficulties Questionnaire provides an overview of mental and emotional health in five scales: emotional symptoms, conduct problems, hyperactivity/inattention, peer relationship problems, and prosocial behavior. Versions for patients, for parents, and for teachers are divided by patient age, from ages 4 to 17, with additional versions for children 2 to 3 and young adults 18 and over. The English versions offer the full range of options for age groups and types of respondent. At least some of these options are available in dozens of languages.
The recently updated CRAFFT substance use screen can be used either as a self-reported questionnaire or a clinician interview with adolescents age 12 to 18. The interview version includes a risk assessment chart, which can be shared with the patient after either version of the screen, and talking points for brief counseling on risk reduction. Both versions come in 15 languages. A brief how-to document and the full CRAFFT manual (PDF) are available from the Center for Adolescent Substance Abuse Research.
Of course, before you decide to screen for mental health issues in a particular language, you’ll want to be prepared to counsel and treat children in that language and to refer the families to culturally appropriate resources in the community. For information on culturally and linguistically competent health care, explore the online toolkit Providing Culturally Effective Pediatric Care from the American Academy of Pediatrics. Throughout the toolkit are links to patient education materials and recordings. One of these is HealthReach from the National Institutes of Health, which offers patient education materials in multiple languages.
Image credit: Jamelle Bouie on Flickr, 2013
“The opportunity to learn information to help me manage psychiatric conditions in my patients in this time where demand clearly outweighs supply of services, is going to be excellent for me as a PCP in my community.”