Project to Learn About Youth – Mental Health II (Re-PLAY)

Kate Flory, PhD, University of South Carolina (Funded 2015-2017)

Internalizing, externalizing, and tic disorders among children and adolescents increase the risk for many negative outcomes. Research is needed to better understand the epidemiology of mental health disorders among youth to inform best practices for identification, prevention, and treatment. The proposed project aims to extend the USC Project to Learn About Youth (PLAY-MH), which has just finished a 2-year period of funding. One of the primary objectives of PLAY-MH is to describe the prevalence and co-occurrence of internalizing, externalizing, and tic disorders among children and adolescents (grades K-12) within a defined population. In the continuation project, existing screening and diagnostic strategies will be implemented a second time within the same population, thereby yielding important information regarding the stability of prevalence estimates and quantifying changes over time. As with the current PLAY-MH, we will also examine mental health treatment in children with previously diagnosed mental disorders and the diversion and misuse of psychiatric medications. We will continue to utilize a two-stage, stratified design for estimating the prevalence of mental health diagnoses and treatment among youth in grades K-12 in the defined population (a rural school district with approximately 10,300 students). In Stage 1, with the exception of students whose parents opt out, all students in the district will be screened for emotional/ behavioral concerns and tic behaviors by teachers using an online screening instrument. In Stage 2, we will conduct 650 diagnostic evaluations targeting equal numbers of high-screen (i.e., those at risk for internalizing, externalizing and tic disorders) and low-screen youth balanced by gender and school level. The diagnostic evaluations will be conducted in-person at a school in the district and will include measures completed by a parent/caregiver and by the child (for children in 4th-12th grade only). Analyses will be conducted using SAS and SUDAAN and will include weights to adjust for the sampling design and strategies accounting for the replication of the project in this population.