Community Health Needs Assessment Theme 10: Prevention Is the Best Care.

Participant Recommendations.

In addition to prevention strategies mentioned in other themes, community health needs assessment participants recommended early screening/identification, more robust programming for children with lower-acuity mental health, and stress response training (aka, coping skills) for all youth.

1. Early screening/identification. Educators and parents say current screening methods/tools are insufficient (or non-existent) for identifying risk or making referrals for assessment. Thus, educators are regularly unable to access the next tier of services. Providers recommend enhancements to universal screening in schools. Parents and educators concur, especially for younger children (e.g., pre-school and elementary school). For adolescents, participants report that insufficient screening results in having to wait for a crisis before assessment and counseling resources are made available. Educators are confident that school-based screenings can identify risk early and prevent a crisis if schools focus on helping youth distinguish between typical stress, learning disability, and disruptive mental health.
2. More robust resources for lower-acuity cases. As noted in Theme 4, parents struggle with obtaining resources for children with mild to moderate symptoms of mental or behavioral health conditions. Educators and providers explain that mental health professionals (e.g., counselors, therapists, social workers) allocate most of their time to Tier 3 (i.e., higher acuity cases). This is due to a variety of reasons, including large caseloads, funding or health insurance restrictions, and lack of training on effective Tier 2 programs/models. Still, while acknowledging workforce shortages and uncertainty in what methods may be the most effective Tier 2 interventions, participants call for more resources for children with lower-acuity mental health.
3. Stress response training (coping skills). Common funding models (e.g., fee-for-service clinical encounters) and workforce capacity limit or block the implementation of prevention-focused activities. So do competing priorities. As noted in Theme 5, the education system emphasizes social-emotional learning and prevention programming in the elementary years, but this focus often fades in high school. Participants recommend providing coping skills training for youth of all ages, particularly middle and high school students, to promote healthier responses to both social and academic stressors. Educators emphasize that integrating this content into the curriculum is essential for broad availability, teacher acceptance, student receptivity, and consistent access. It is recommended that youth be engaged as partners in the design and implementation of Tier 1 prevention programs like stress response training; incorporating their advice and perspective is necessary to secure buy-in and participation.

Tiered Prevention Strategies.

Providers and many educators use a Multi-Tiered System of Support (MTSS) framework to explain prevention strategies. They recommend more Tier 1 (Universal Support) and Tier 2 (Targeted Support). Community spaces (Theme 6), teacher training (Theme 5), and parenting skills (Theme 3) are examples of Tier 1 interventions described in other themes of the community health needs assessment.