Expanding Behavioral Health Data Collection: Serious Emotional Disturbance (SED) in Children



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Expanding Behavioral Health Data Collection: Serious Emotional Disturbance (SED) in Children Center for Behavioral Health Statistics and Quality Substance Abuse and Mental Health Services Administration June 11, 2015

OVERVIEW OF SED STUDY J. NEIL RUSSELL, DIRECTOR, DIVISION OF SURVEILLANCE AND DATA COLLECTION, CENTER FOR BEHAVIORAL HEALTH STATISTICS AND QUALITY, SAMHSA 2

Introduction U.S. Department of Health and Human Services seeks to expand behavioral health data collection. Require guidance on how to best measure and collect these data. SAMHSA working through ASPE to engage the Committee on National Statistics (CNSTAT)/National Research Council (NRC). 3

Expand Behavioral Health Data Guidance needed on how to measure and collect data on these behavioral health topics: Topic 1: Specific adult mental illness including functional impairment Topic 2: Serious Emotional Disturbance (SED) in children Topic 3: Trauma Topic 4: Recovery 4

Serious Emotional Disturbance (SED): Legislation In 1992, the Alcohol, Drug Abuse, and Mental Health Administration (ADAMHA) Reorganization Act established a block grant for Community Mental Health Services to be administered by SAMHSA. This block grant provides funds to States to support services for children with serious emotional disturbance (SED) and adults with serious mental illness (SMI). 5

SED Background SAMHSA has a legislative mandate to collect SED estimates at the national and state level. SED has a set definition. The definition of past year SED has two main components mental disorders and impairment. 6

SED Definition in 1993 Federal Register "Children from birth up to age 18 who currently or any time during the past year have had a diagnosable mental, behavioral, or emotional disorder of sufficient duration to meet diagnostic criteria specified within [the then current] DSM III R which has resulted in functional impairment which substantially interferes with or limits the child's role or functioning in family, school, or community activities." 7

SAMHSA SED Work SAMHSA convened two non-nrc expert panels; they provided guidance on which DSM 5 disorders should and should not be included in the SED definition research on what instruments are currently available to measure these disorders and impairment within SED definition 8

Challenges to Collecting SED Data There are instrumentation development and measurement challenges. Need guidance on best and appropriate instruments to use for measuring SED. If certain instruments are not appropriate for study or data collection mode, need specific instrumentation development work. 9

Challenges to Collecting SED Data Instrumentation-related guidance should take estimation methods and design features into account. For example: Instrumentation validation across the mode of data collection and the population of interest. Impact of different age-appropriate instruments on the effect of continuity of estimates. Availability of Spanish instrumentation. 10

Collect SED Data Possible means of collecting the data: Use the National Survey on Drug Use and Health (NSDUH), Reinstate the Mental Health Surveillance Study (MHSS), Develop a new data collection program, Use existing data, and/or Guidance needed on estimation method (which may effect design options and vice versa): Construct model-based estimation procedures using existing data sources. 11

SED Workshop Charge Provide guidance on how to measure Serious Emotional Disturbance (SED) in children Consider survey and questionnaire design tradeoffs Assess mechanisms for collecting the data and provide suggestions Provide suggestions for measuring these data and assess potential impact of changes to NSDUH Discuss or present commissioned papers 12