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
Yes
No
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
