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Personalized Mental Health Navigator to Promote Early Engagement, Linkage and Coordination of Needed Mental Health Services for Children and Adolescents

NAMHC Concept Clearance

Presenter:

Denise Pintello, Ph.D.
Division of Services and Intervention Research

Goal:

This initiative proposes to develop and test the effectiveness of a navigator model designed to promote early engagement, linkage and coordination of mental health treatment and services for children and adolescents who are identified with early onset mental illness symptoms, or are at high risk for developing mental illnesses.  A navigator is a health care provider assigned to work with youth and families to obtain needed treatment and services. To date, several variations on the use and type of navigators across related health care fields have been tested.

Rationale:

The onset of mental illnesses frequently occurs during childhood or adolescence. Several studies suggest that sub-clinical mental illness symptoms reported in late childhood and early adolescence predict psychotic disorders in adulthood.  These emerging mental illness symptoms, if left untreated, are likely to develop into psychological disorders with long-lasting effects.  Research findings and recent reports suggest that early intervention programs, such as the Recovery After an Initial Schizophrenia Episode (RAISE), are effective at interrupting the developmental trajectory of mental illnesses, and improving clinical and functional outcomes for children and adolescents. Patient navigator models have precedence in cancer studies. Recently completed studies in cancer care reported successful outcomes with a patient navigator model, resulting in increased treatment access, adherence, and compliance.  Moreover, multiple studies demonstrate that cancer patient navigator interventions are most effective among patients from minority and underserved populations.

Applying a navigator model to the field of mental illness has potential to enhance treatment and service delivery for youth, and to help family members negotiate complex health care processes. As well, it may reduce health disparities. Providing a ‘Personalized Mental Health Navigator’ for youth at the earliest sign of mental illness has high potential to increase engagement, access, linkage and coordination of mental health services for children and families.  Additionally, recent advances in technology (e.g., dashboards, outcome tracking, and therapeutic milestone measurement) can provide important data to personalize mental health care for each child and adolescent, and could inform efforts to match youth to the required treatment modality, intensity, dosage and frequency.

This initiative aims to develop and test care coordination strategies and technologies to help identify, engage and match youth to mental health treatment and services, and to work with youth and families over an extended period of time to ensure that therapeutic gains are maintained.  Long-term outcomes include the development of a body of generalizable knowledge regarding 1) effective mental health navigation models; 2) impact on health disparities among underserved populations; and 3) research-informed strategies to improve care coordination and to match youth with appropriate treatment and services.

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