Implementing Behavioral Health Screening for School Age Children: A Pilot Study at Dorchester House Community Health Center

Behavioral health conditions in children are largely undiagnosed and untreated particularly in communities that are low income and culturally diverse. Massachusetts requires mental health screening for all Medicaid eligible children. We undertook a study to assess the sensitivity and specificity of the Pediatric Symptom Checklist (PSC) in a federally qualified health center, where 85% of the patient population lives at or below 200% of the Federal Poverty Level. The 17-question PSC was administered to parents of children ages 6 to 12 years during routine visits. It was available in English, Spanish, and Vietnamese. PSC tools were scored according to standard procedures. We performed chart reviews for each child to compare the PSC scores to previously identified behavioral health concerns. Using this data we determined the sensitivity and specificity of the PSC. In this pilot study 50 screens were analyzed. 4 had scores that met criteria for a positive screen. Of these, 3 children had behavioral health concerns previously documented in their record. Of the 46 negative screens, 10 children had behavioral health concerns documented in their record. The PSC had a sensitivity of 0.23 and a specificity of 0.97. The low sensitivity is consistent with similar studies. The goal of screening is early identification of children with behavioral health risks; with this in mind, results showed that clinical practices at this health center were superior to the screening tool. We will present updated results of screening in this population that will examine differences by race and socioeconomic status.