Putting RAAPS into Practice: Chemawa Indian Health Center

The Chemawa Indian Health Center operates on the campus of over a century-old Native American boarding school in Salem, OR.  It’s home to as many as 400 students, who represent about 70 tribes from across the country.

The students are at risk because of their age and their culture. Suicide is the second-leading cause of death among Native American teens (ages 10-34), and incidence of alcoholism, drug and tobacco use, accidents, and homicide are high.

Jennifer Behnke, a psychiatric mental health nurse practitioner at the federally funded Indian Health Services clinic, works with students age 14 to 19. Before she discovered the online Rapid Adolescent Prevention Screening (RAAPS) system several years ago, the center used a 19-page, hand-written social history screening.  The teens lost interest after a few pages, staff took weeks to evaluate the results, and risk identification was greatly subjective.

“These students come in with multiple risk factors and, they require a quicker more standardized method of risk screening,” Behnke said.  “A large survey not working, nor was it effective at identifying who was at risk. So RAAPS was a requirement in my mind.”

Identifying Highest-Risk Kids on the First Day

Once RAAPS was implemented, Behnke and her colleagues could identify the highest-risk teens and schedule them for an assessment that same day. That process previously took several weeks. “These kids could be suicidal, depressed and perhaps liked to drink,” she said. “We needed to get to them quicker.”

Today, 90 percent of students take the survey annually. Every student’s demographics are entered at the beginning of the school year, allowing them to finish the RAAPS survey in 3-5 minutes.  This is accomplished by rotating them through a computer lab at the beginning of the school year.  Counselors immediately see a report that identifies which students need to be seen in the clinic right away.

The clinic staff first identifies risk based on the top questions (suicide/self-harm, depression, history of carrying weapons). Using the RAAPS reporting functions, an analysis of the entire population is done in a matter of hours and the highest-risk youth are triaged for immediate follow-up.

“This has vastly improved our overall practice. It reduces time and improves the accuracy of identifying teens at risk in a more consistent and objective way,” Behnke said. “This helps us help more kids more effectively.”

Read more about the Chemawa Indian Health Center and how they put RAAPS into practice by viewing their case study.

Contact us today with questions about how to effectively integrate RAAPS into your practice!

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