Hello, and welcome to the second post in our “Approaches to Measuring Quality Improvement in Public Health” series! While quality improvement principles have traditionally been implemented in clinical settings, this series is focused on unpacking a measurement framework to apply a  Q.I model/ lens to public health, systems-level work. In our most recent post, we introduced the leadership domain of the framework, which featured how the Minnesota Adolescent and Young Adult Behavioral (AYA BH) CoIIN team have laid the foundation for creating a climate that encourages prioritization of AYA emotional wellness in their state.

The leveraging existing initiatives of this QI  framework emphasizes the importance of finding and enhancing synergies between active programming to address an issue.  More specifically, this domain asks public health teams to consider the following questions: What existing initiatives align well with what my project is trying to achieve? Is my organization invited to the table for these projects? On the flip side, which voices are missing from our own projects and efforts? An important note for this domain: inviting others to your initiative isn’t necessarily the priority.  Showing up and being willing to pitch in to someone else’s initiative can be just as impactful, and still ultimately works toward the overall goal of creating synergy between stakeholders working towards a common aim in order maximize efficient use of resources.  Read on to learn how the South Carolina AYA BH CoIIN team prioritized this domain as a part of their work to align efforts for improving AYA emotional well-being in their state. 

Leveraging Existing Initiatives in South Carolina
By Rebecca Williams-Agee, South Carolina’s Adolescent Health Program Coordinator

In South Carolina, the AYA Behavioral Health CoIIN team is focusing on leveraging existing initiatives by adding the MCH perspective and capacity.  As the team in SC has grown, it has become increasingly apparent that there are numerous initiatives that exist statewide and regionally which focus on optimal emotional well-being for adolescents and young adults.  Identifying, connecting and building on the work of these initiatives has become a major emphasis for the SC team, in addition to developing the presence of MCH as a part of them.  Identified initiatives include the following:

• The SC Behavioral Health Coalition is a voluntary, multidisciplinary, long-term statewide partnership of both public and private organizations devoted to enhancing and improving access to a comprehensive system of behavioral health care.  This diverse group includes a subgroup that specifically prioritizes the emotional well-being of Children and Youth.  The Coalition overall is responsible for establishing both short and long-term goals with a primary focus on identifying and disseminating actions based on the needs of individual communities, and this subgroup focuses on those needs specific to children and young adults.
• The SC Suicide Prevention Task Force was created with to strengthen statewide infrastructure that will support improved behavioral health services delivery to potentially suicidal youth and young adults through this task force and regional youth suicide prevention task forces.
• The Child Wellbeing Coalition is a group of local and state agencies, community members and organizations committed to working collectively to mitigate the effects of poverty on children.  This Coalition includes multiple workgroups, but the education and health workgroups have chosen to include a focus on behavioral health among youth and young adults.
• Community Crisis Response and Intervention (CCRI) Teams have been developed by the SC Department of Mental Health to provide adults and children access to clinical screening in person at the location of the crisis, at a community mental health center, via phone or telehealth communication software.
• Additionally, multiple inter-agency and intra-agency workgroups and collaborations related specifically to the needs of adolescents and young adults have been identified, including the SC Department of Health and Environmental Control School Aged Youth Workgroup and the SC Telehealth Alliance.

As these initiatives have been identified, CoIIN members have determined that the most effective way to further our objectives is to become actively involved with the existing work rather than beginning a new one with a very similar focus.  The AYA CoIIN has been incorporated as a school and community-based workgroup of the larger Children and Youth subgroup of the Behavioral Health Coalition.  Members of the CoIIN have become involved in the Suicide Prevention Task force and have plans to incorporate their work into the state-specific information provided to participants in the clinical arm of the CoIIN, as is also the case with the CCRI teams under the Department of Mental Health.  The Child Wellbeing Coalition has also included the CoIIN goals in the overall focus of the Health and Education workgroups, in addition to assisting with the identification of funds to support ongoing work of CoIIN ideas and initiatives in local communities.

Specific achievements of the SC CoIIN that have resulted from leveraging existing initiatives include the following:

1. In the Behavioral Health Coalition and CWB Coalition, the goals and initiatives of the CoIIN have become the group goals for AYA Behavioral Health focus.
2. The CoIIN is working with additional initiatives to combine goals and objectives, specifically those related to school behavioral health response.  The results of a survey sent to school nurses across the state related to the behavioral health support available for students within their specific communities are being shared directly with the CoIIN.

Overall, leveraging existing initiatives has become an ongoing focus of the AYA CoIIN in SC, and will continue to guide the work of the group moving forward.

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