InCrisis Reports: Foundation for Services

StepOne services were developed in response to issues in  the needs assessment, practice guidelines and recommendations described  in the US Surgeon General's Report on Mental Health, the President's New Freedom Commission on Mental Health (NFC) and the Emergency Response: A Roadmap For Federal Action On America's Mental Health Crisis.

In response, the American Psychological Association (APA) passed a resolution on children’s mental health and funded two task forces to outline the role psychology should play as a leader in a national reform effort. Both task forces concluded that the public, the policy makers, and many professionals remain unaware of the problem, recommending that increased awareness both inside and outside of psychology be a top priority

Based on the 2000 US Census Report, we estimate there are 39.4 million children 12 to 17 year old in the US today. In 2001, the Surgeon General estimated that nearly 1 out of 10 children have a diagnosable addictive or mental disorder that significantly impairs their mental, emotional and social functioning. One out of 5 have a serious behavioral or emotional problem that interferes with peer, family and social activities. Of these children, an estimated two out of three will NOT be identified or get the help they need. The bottom line? An estimated 6.6 million emotionally disturbed and 2.6 million severely disturbed children are not getting the help they need in a timely manner. The reasons include a lack of screening, a scarcity of professionals who work with adolescents, an inability to find help and the cost.

According the the APA, the costs to our country are staggering. Untreated mental health problems in children can lead to tragic consequences, including suicide, violence, substance abuse, inability to live independently, incarceration, lack of vocational success, and health problems. Not only are families affected, but also communities, schools, employers, and the nation as a whole.

The President's NFC has a number of findings and recommendations that are addressed  but the mission and services provided by StepOne. Relevant sections of NFC's findings regarding mental health are as follows

"...Transforming the [mental health] system so that it will be both consumer and family centered and recovery-oriented in its care and services presents invigorating challenges. Incentives must change to encourage continuous improvement in agencies that provide care. New, relevant research findings must be systematically conveyed to front-line providers so that they can be applied to practice quickly. Innovative strategies must inform researchers of the unanswered questions of consumers, families, and providers. Research and treatment must recognize both the commonalities and the differences among Americans and must offer approaches that are sensitive to our diversity. Treatment and services that are based on proven effectiveness and consumer preference - not just on tradition or outmoded regulations - must be the basis for reimbursements.

The Nation must invest in the infrastructure to support emerging technologies and integrate them into the system of care. This new technology will enable consumers to collaborate with service providers, assume an active role in managing their illnesses, and move more quickly toward recovery."

NFC Recommended Goals

• Goal 1 - Americans Understand that Mental Health Is Essential to Overall Health.

• Goal 2 - Mental Health Care Are Consumer and Family Driven.

• Goal 3 - Disparities in Mental Health Services Are Eliminated.

• Goal 4 - Early Mental Health Screening, Assessment, and Referral to Services Become Common Practice

• Goal 5 - Excellent Mental Health Care Is Delivered and Research Is Accelerated.

• Goal 6 - Technology Is Used to Access Mental Health Care and Information.

The NFC identified the following six goals as the foundation for transforming mental health care in America.

Goal 1. Americans Understand that Mental Health Is Essential to Overall Health.

"...In a transformed mental health system, Americans will seek mental health care when they need it - with the same confidence that they seek treatment for other health problems. As a Nation, we will take action to ensure our health and well being through learning, self-monitoring, and accountability. We will continue to learn how to achieve and sustain our mental health."

Goal 2. Mental Health Care Are Consumer and Family Driven.

"...An individualized plan of care will give consumers, families of children with serious emotional disturbances, clinicians, and other providers a valid opportunity to construct and maintain meaningful, productive, and healing relationships."

Goal 3.  Disparities in Mental Health Services Are Eliminated.

"...all Americans will share equally in the best available services and outcomes, regardless of race, gender, ethnicity, or geographic location. Mental health care will be highly personal, respecting and responding to individual differences and backgrounds."

"...In rural and remote geographic areas, service providers will be more readily available to help create a consumer-centered system. Using such tools as videoconferencing and telehealth, advances in treatments will be brought to rural and less populated areas of the country. These technologies will be used to provide care at the same time they break down the sense of isolation often experienced by consumers."

Goal 4. Early Mental Health Screening, Assessment, and Referral to Services Become Common Practice.

"...In a transformed mental health system, the early detection of mental health problems in children and adults - through routine and comprehensive testing and screening - will be an expected and typical occurrence. At the first sign of difficulties, preventive interventions will be started to keep problems from escalating. For example, a child whose serious emotional disturbance is identified early will receive care, preventing the potential onset of a co-occurring substance use disorder and breaking a cycle that otherwise can lead to school failure and other problems.

Quality screening and early intervention will occur in both readily accessible, low-stigma settings, such as primary health care facilities and schools, and in settings in which a high level of risk exists for mental health problems, such as criminal justice, juvenile justice, and child welfare systems. Both children and adults will be screened for mental illnesses during their routine physical exams.

For consumers of all ages, early detection, assessment, and links with treatment and supports will help prevent mental health problems from worsening. Service providers across settings will also routinely screen for co-occurring mental illnesses and substance use disorders. Early intervention and appropriate treatment will also improve outcomes and reduce pain and suffering for children and adults who have or who are at risk for co-occurring mental and addictive disorders."

Early detection of mental disorders will result in substantially shorter and less disabling courses of impairment. "

Goal 5.  Excellent Mental Health Care Is Delivered and Research Is Accelerated.

"In a transformed mental health system, consistent use of evidence-based, state-of-the art medications and psychotherapies will be standard practice throughout the mental health system. Science will inform the provision of services, and the experience of service providers will guide future research. Every time any American - whether a child or an adult, a member of a majority or a minority, from an urban or rural area - comes into contact with the mental health system, he or she will receive excellent care that is consistent with our scientific understanding of what works. That care will be delivered according to the consumer's individualized plan."

Goal 6.  Technology Is Used to Access Mental Health Care and Information.

"...In a transformed mental health system, advanced communication and information technology will empower consumers and families and will be a tool for providers to deliver the best care. Consumers and families will be able to regularly communicate with the agencies and personnel that deliver treatment and support services and that are accountable for achieving the goals outlined in the individual plan of care. Information about illnesses, effective treatments, and the services in their community will be readily available to consumers and families.

Access to information will foster continuous, caring relationships between consumers and providers by providing a medical history, allowing for self-management of care, and electronically linking multiple service systems. Providers will access expert systems that bring to bear the most recent breakthroughs and studies of optimal outcomes to facilitate the best care options."

The Mission of StepOne

StepOne Reports are designed involve, educate and empower parents to seek the care they feel is appropriate while protecting parental rights and responsibilities.

The mission of StepOne is to provide internet-based analysis, screening, education and referral support services for parents and caretakers with teenage children who do not have timely or affordable access to qualified mental health care services. We will strive to make our services affordable, reliable, valid and useful. Our services will be designed and promoted to enhance and complement the role of face-to-face professional services.  StepOne will conduct research that benefits society and allows us to ensure the quality and ongoing improvement of our services.

InCrisis Reports Services

InCrisis reports develops online information resources and processing services that are available on the Web. The company offers and develops computer-assisted interviews and behavioral analyses for families or caregivers with children ages 12 to 17. This service uses a form of expert system computer technology.

InCrisis reports was created because the behavioral and mental health problems facing parents and children are larger than our current health care system's capacity to address in a timely manner. The goal of StepOne is to support parents, schools, health care agencies, and health care professionals with mental health education and personalized information.

InCrisis reports is based on a premise that no educational or information processing service can replace the value of face-to-face assessment and treatment by a qualified professional. We provide an optional and logical first step for parents and informed caregivers who live in remote areas, those who do not have access to qualified mental health professionals and those who cannot afford or locate appropriate screening and evaluation services.  We believe that meaningful  and useful information is the first step in getting help. We believe that families have both a right and a need for screening services that empowers families to seek help and to monitor their child's health and well being. StepOne does not provide professional evaluation, assessment, treatment, diagnostic or emergency services. Our Web site users are customers and are not patients.

The development and operation of this Web site is based on research as well as formal consultation and professional review.  StepOne has taken reasonable steps to ensure that the services provided are both professional and ethical.

StepOne questionnaires and reports are designed to provide a comprehensive and reliable method to gather, organize and present information in a manner that can be useful to parents, caregivers, education experts and health care professionals. StepOne services support the NFC's findings and recommendations. The purpose is to support families, children and research, as well as appropriate and necessary education and health care services.

InCrisis Reports Research Activities

InCrisis reports and resources are developed first for parents and second for professionals who will review screening reports based entirely on information provided by parents and caregivers. StepOne is also conducting research to improve its services. The StepOne Website construction and information-processing procedures aspire to and in many cases exceed standards suggested in guidelines and publications by the American Psychological Association.

Standardization and statistical information regarding scales and the logic of StepOne information processing are intellectual property. Legitimate inquires for purposes of research are welcome. Professional guidance and research pertaining to StepOne Reports is through agreement with Mentor Research Institute (MRI), a nonprofit 501(c)3 corporation. Research programs are  managed by MRI. Users have the option to prevent  their responses from being used for research purposes. The results of  research will not be presented in ways that would allow readers to identify individuals.

References

Mental Health: A Report of the Surgeon General.  Rockville, MD.: U.S. Department of health and Human Services, Substance Abuse and Mental Health Services Administration, Center for Mental Health Services, National Institute of Mental Health, 1999.

Revised: December 30, 2007