Adolescent Health Progress Report (October 1, 2021-September 30, 2022)

The 2020 comprehensive Title V needs assessment process led to the development of the

Priority Need: Improve Coordinated and comprehensive health promotion efforts among the child and adolescent populations. Several strategies were identified and incorporated into the state action plan to impact Title V National Outcomes Measures and National Performance Measures to reduce mortality and improve health outcomes for the adolescent population.

The work in SC surrounding improvements to coordinated and comprehensive health efforts among the adolescent population is extensive in hopes to address complex issues (e.g., build resiliency by providing support services at the community level, address mental/behavioral health issues in a variety of settings, ensure well-child visits for adolescents are comprehensive and include certain provisions).

NOM 16.1: Adolescent mortality rate

NOM 16.3: Adolescent suicide rate

NOM 18: Percent of children and adolescents with a mental/behavioral condition who receive treatment or counseling

The State Adolescent Health Coordinator (SAHC), housed within DHEC’s MCH Bureau, is engaged with SC’s Adolescent and Young Adult Behavioral Health Collaborative Improvement and Innovation Network (CoIIN) which works to build resilience among children through safe and supportive environments. CoIIN members met monthly throughout the reporting period, and includes participants from the SC Telehealth Alliance, the Quality through Technology and Innovation (QTIP) program, MUSC Children’s Hospital, Department of Mental Health, the National Alliance for Mental Illness SC (NAMI), parent representatives and other community and organizational participants. CoIIN meetings have included troubleshooting for members related to student outreach, provision of mental health services, and parental support around adolescent and young adult behavioral health issues. The SAHC has been actively meeting with the National Network of State Adolescent Health Coordinators (NNSAC) group that works closely with Association of Maternal and Child Health Programs (AMCHP). The NNSAC provides resources and networking around adolescent mental and reproductive health.

As reported in the Child Health narrative, school nurses have become more involved in the mental and behavioral health concerns of their students. School nurses have begun to link students to community resources (including health insurance), connect students to school-based resources, and ensure a safe space is provided for struggling students.   The State School Nurse Consultant in partnership with Lowcountry AHEC and the SC Association of School Nurses has facilitated professional development opportunities for school nurses to increase their skills related to prevention, intervention and postvention of mental health crises, including suicide.

NPM 10: Percent of adolescents, ages 12 through 17, with a preventive medical visit in the past year

The Preventive Health program, within MCH’s Women’s Health Division, continues to provide reproductive health care services, counseling, and education to teens and adolescents by caring professionals in safe, supportive, teen-friendly clinics. Some of the services provided to adolescents at these sites include birth control methods available on site (including emergency contraception); provision of up to a year's supply of birth control; pregnancy testing; STI/HIV screening; education in abstinence; training in resisting coercion; and encouraging family involvement. During this reporting period, preventive health sites across the state served 311 adolescents under 15 years of age; 1,920 15–17-year-olds; 2,644 18–19-year-olds; and 8,858 20–24-year-olds, totaling 13,733 individual clients under the age of 24. These preventive and reproductive health activities impact NOM 23: The teen birth rate.

The SAHC serves as the program manager for the Personal Responsibility and Education Program (PREP). Through PREP, six counties, in different regions across the state, receive funding to implement evidence-based interventions for teen pregnancy prevention and STI/HIV prevention. The program emphasizes the importance of the following: open communication between adolescents and parent/caregiver/trusted adults; healthy life skills and healthy relationships. During this reporting period, SC PREP continued funding to Dillon, Florence, Richland, Spartanburg, Lancaster, and Laurens Counties and their Community Work Groups (CWGs). All 6 counties ranked high for cases of STIs and low for overall community well-being. The SAHC provided technical assistance, training, and resources to these counties to support the development of CWGs; implementation of Evidence-Based Teen Pregnancy Prevention curriculum; and community-based events focused on the development of protective factors for adolescents. During this funding period, the University of South Carolina opened DHEC’s first satellite clinic on their Lancaster County campus. This clinic provides the same preventive health services as the local health department.    

During this reporting period, COVID-19 continued to limit the access of PREP partners to the youth and parents in their communities. To strengthen availability and access to telehealth services for adolescents, the SAHC worked with community members to provide support for online events and curriculum implementation. The focus on providing mental and behavioral health services that are accessible to adolescents has been an even bigger focus through the Adolescent and Behavioral Health CoIIN, because of the COVID-19 pandemic.   

Table 4. Significance* Testing for Adolescent Health Measures