News Briefs

New toolkit to help identify children at risk: Three in four youths with emotional and behavioral problems are not identified. In 2001 the U.S. Surgeon General called for development of a set of simple warning signs to help identify at-risk youths. The Action Signs Project, funded by the Center for Mental Health Services and the National Institute of Mental Health, has released a set of 11 action signs in a toolkit of dissemination materials and training guidelines designed for a variety of stakeholders. The 11 action signs, developed via review of epidemiologic data sets and based on DSM-IV criteria, are written in nonstigmatizing language, and to ensure that they are easily understood, developers sought input from more than 6,000 children and parents. The action signs alert physicians, teachers, parents, and others that children are at risk when they feel very sad or withdrawn for more than two weeks; try to harm themselves or make plans to do so; experience sudden overwhelming fear for no reason; are involved in many fights, use a weapon, or want to badly hurt others; display severe out-of-control behavior that can hurt themselves or others; are not eating or shows signs of throwing up or using laxatives to lose weight; have intense worries or fears that get in the way of daily activities; demonstrate extreme difficulty in concentrating or staying still that puts them in physical danger or causes school failure; repeatedly use drugs or alcohol; show severe mood swings that cause problems in relationships; and display drastic changes in behavior or personality. The toolkit includes a poster for use in doctors' offices and schools, handouts for parents and youths, and stickers for use as prompts in medical charts. The project was developed at the Center for the Advancement of Children's Mental Health at Columbia University-New York State Psychiatric Institute and completed by investigators at the REACH (Resource for Advancing Children's Health) Institute and at the Mayo Clinic. The 56-page toolkit is available on the REACH Web site at www.thereachinstitute.org/action-signs-static.html.