Yes
No
Crisis - You feel your child is in IMMEDIATE danger; talking about hurting themselves or someone else
Emotional Distress- (Depression, anxiety, tearfulness, excessive worry, irritability, not enjoying things they used to)
Behavioral Problems (acting out behaviors, not following rules for safety, destroying things, angry outbursts, hitting or threatening)
Drug and/or Alcohol use
Both substance use AND other emotional/behavioral health concerns
Eating Problems
MILD No prior treatment history and/or symptoms have limited impact on daily life
MODERATE- Symptoms are negatively impacting daily functioning at home, school and/or work.
SEVERE- My child's emotional difficulties are highly disruptive at home, school, work and/or in the community. My child has a significant psychiatric diagnosis and/or is at risk of hospitalization or is being discharged from a hospital and will need a high level of therapeutic support
MILD - Misusing drugs or alcohol, but the use is not frequent and/or there have not been any serious consequences
Moderate - Use of drugs or alcohol is causing problems in at least one area (school/work, relationships, home)
SEVERE - Frequent use of drugs and/or alcohol is creating problems in multiple areas such as: School/work attendance/performance; relationships with peers or family; illegal activity; high risk behavior; or I am concerns that my child woruld not be able to stop using drugs and/or alcohol even if they wanted to.
MILD
MODERATE
SEVERE
Crisis The individual is in IMMEDIATE danger; talking about hurting themselves or someone
Emotional Distress - Depression, anxiety, tearfulness, excessive worry, irritability, not enjoying things they used to
Behavioral Problems - acting out behaviors, not following rules for safety, destroying things, angry outbursts, hitting or threatening
Substance Misuse
Both emotional/behavioral health concern(s) AND drug/alcohol use
MILD- No prior treatment history and/or the symptoms have limited impact on daily life
MODERATE- Symptoms are negatively impacting daily functioning at home, school, and/or work
SEVERE - The emotional difficulties are highly disruptive at home, school, work and/or in the community; my child has a significant psychiatric diagnosis and/or is at risk of hospitalization or is being discharged from a hospital and will need a high level of therapeutic support
MILD - No prior treatment history and/or symptoms have limited impact on daily life
MODERATE - Symptoms are negatively impacting daily functioning at home, school and/or work
SEVERE - The behavioral difficulties are highly disruptive at home, school, work and/or in the community; my child has a significant psychiatric diagnosis and/or is at risk of hospitalization or is being discharged from a hospital and will need a high level of therapeutic support
Psychosis - e.g. seeing or hearing things that are not real, "bizarre" beliefs or behaviors and/or has had multiple psychiatric hospitalizations
MODERATE- Use of drugs and/or alcohol is causing problems in at least one area of life (school, work, home, relationships)
SEVERE - Use of drugs and/or alcohol is frequent and is creating problems in multiple areas such as: school or work attendance/performance; relationships with peers or family; illegal activities; high risk behaviors; or I am concerned that my child would not be able to stop using even if they wanted to
MODERATE - The drug and/or alcohol use and other problem behaviors have been increasing; there is quite a bit of tension at home.
SEVERE - high risk for negative outcomes including injury, criminal justice involvement, school drop out, risk of drug overdose event, any opioid use; high risk of out-of-home placement or is just returning to community from placement and is need of a high level of support
