Early Identification & Prevention
About Us
Spot concerns early and act quickly so families receive respectful screening, immediate brief support, and a warm connection to care in the places they already go.
Find concerns early and act early
Build simple, family-centered ways to spot behavioral health needs before they escalate. Make screening, brief intervention, and warm connection to care a routine experience in prenatal, pediatric, school, and community settings.
What success looks like
Families get timely, respectful screening in places they already go.
Positive screens lead to closed-loop follow through within 7 days.
Brief supports are available immediately while longer care is arranged.
Gaps shrink first for groups with the longest waits and lowest connection rates.
Communities see fewer crises and fewer preventable emergency visits.
Where we will focus first
Perinatal & Infant: universal depression, anxiety, and substance use screening with rapid peer and clinical follow up.
Early Childhood: developmental & social-emotional screening in WIC, home visiting, child care, Early Head Start, and primary care.
School-Age: classroom-ready tools for behavior, attention, mood, and substance risk with quick consults for educators.
Transition-Age Youth: early psychosis, suicide risk, and substance use identification in schools, colleges, primary care, and youth programs.
What we will stand up
A shared “front door” playbook that any setting can use to screen, talk with families, and connect to help without extra forms.
Brief support pathways like same-week skill groups, guided self-help, and care navigation so help starts right away.
Consult lines for helpers that give real-time coaching to educators, primary care, home visitors, and community staff.
Family-friendly results letters and scripts in multiple languages that explain what the screen means and what happens next.
Near-term actions
Standardize the front door: short, validated tools by age/setting; opt-in consent; plain-language scripts; clear next steps.
Close the loop: outreach ≤48h and first kept appointment ≤14 days; track status to confirmation or decline.
Offer help while families wait: text coaching, drop-in parent sessions, youth skills groups, peer support.
Launch school & child care pilots: educator-ready checklists, classroom strategies, and a same-week consult slot per region.
Equip prenatal & pediatric sites: EHR templates, standing orders, billing tips, and warm-handoff workflows.
Fund community & Tribal partners: multi-year, flexible contracts for outreach, screening events, and culturally grounded supports.
Train the workforce we have: short, role-based training; safety planning; privacy; bilingual differentials verified by proficiency.
Built-in standards
No wrong door: any positive screen can start a connection to care.
Qualified interpreters on demand for phone, clinic, school, community, and telehealth.
Translated intake, consent, and rights in top regional languages.
Alternative formats for all materials, including large print and screen reader ready.
Minimal data, maximum clarity; secure storage; explain use to families.
Family choice & consent at each step, including who sees the plan and how information is shared.
Equity commitments
Disaggregate screening, follow-through, and experience by race, ethnicity, language, disability, geography, LGBTQIA2S+, and payer.
Co-design tools/scripts with families, youth, lived & living experts; fund participation.
Prioritize regions and groups with the largest gaps for pilots, staffing, and outreach.
Fund Tribal and community-led models to co-own design, delivery, and improvement.
Measures we will publish
Reach & timeliness
Percent screened by setting/age; time from positive screen to first outreach and first kept appointment; closed-loop ≤48 hours.
Connection & continuity
Percent of positive screens starting brief support within 7 days; follow up within 7 days after level-of-care change.
Experience & equity
Family/youth ratings of respect, understanding, ease; gap closure on reach & follow-through by group and region.
System impact
Preventable emergency visits related to behavioral health among 0–25; school days missed related to behavioral concerns.
Data, privacy, and consent
Use a single, plain-language consent that explains what is collected, who sees it, and how it helps.
Share only what is necessary for coordination through consented shared care plans.
Provide families copies of results and next steps in their preferred language and format.
Roles at a glance
Schools & Early Learning: screen, share classroom strategies, quick consults, warm handoffs to navigation.
Primary & Prenatal Care: screen, brief intervention, safety planning, prescribing where appropriate, warm handoffs.
Community & Tribal Partners: outreach, events, culturally grounded supports, peer/family navigation.
Regional Navigation: confirm every handoff, schedule quickly, stay until connection is confirmed.
State & Funders: common tools & billing pathways, flexible contracts, public reporting, improvement supports.
30–60–90 day rollout
Days 1–30
Confirm core tools and scripts by setting. Stand up consult lines. Publish how to refer in each region. Baseline measures.
Days 31–60
Launch closed-loop follow-through for positive screens. Start brief support options. Begin school & child care pilots.
Days 61–90
Expand prenatal & pediatric coverage. Validate equity impacts with community advisors. Publish first public progress update.
What families can expect
A short, respectful conversation in familiar places.
Clear results and next steps in the language used at home.
A named person to help schedule and answer questions.
Immediate help options while longer care is arranged.
How we will learn and improve
Monthly regional huddles to review measures, stories, and barriers.
Rapid tests of change with families and staff, published openly.
Quarterly updates showing where gaps are closing and what fixes are next.
Early identification and prevention work when they are simple, trusted, and fast. This plan makes them part of everyday care in every region, with results families can see.
